Perumal Ramesh, Gaddam Santhosh Ram, Vasudeva J, Dheenadhayalan J, Rajasekaran S
Department of Orthopaedics, Ganga Hospital, Coimbatore, Tamil Nadu, India.
J Orthop Case Rep. 2017 Jan-Feb;7(1):54-57. doi: 10.13107/jocr.2250-0685.686.
Femoral neck fractures are a common occurrence in lower limb amputees. Good post-operative results of hip hemiarthroplasty have been described in below-knee amputees. However, to our knowledge, very few such cases have been reported in above-knee amputees.
We present a case of a 75-year-old male patient who underwent above-knee amputation of the right lower limb for severe crush injury right leg and a bipolar hemiarthroplasty for an ipsilateral fracture neck of femur sustained in the same road traffic accident. The treatment of neck of femur fracture in above-knee amputee patients is always a challenge for the orthopedic surgeon. We described the surgical technique in an attempt to overcome the challenges encountered in such a setting.
While performing a hemiarthroplasty in an above-knee amputee, we recommend the use of two perpendicularly placed Schanz pins distally in the subtrochanteric area for control and also as a guide for verifying the version during prosthesis placement.
股骨颈骨折在下肢截肢患者中很常见。对于膝下截肢患者，髋半关节置换术的术后效果良好。然而，据我们所知，很少有关于膝上截肢患者的此类病例报道。
我们报告一例75岁男性患者，其因右腿严重挤压伤接受了右下肢膝上截肢术，并因在同一起道路交通事故中遭受的同侧股骨颈骨折接受了双极半关节置换术。对于膝上截肢患者的股骨颈骨折治疗，一直是骨科医生面临的挑战。我们描述了手术技术，试图克服在这种情况下遇到的挑战。
在膝上截肢患者中进行半关节置换术时，我们建议在转子下区域向远侧垂直放置两根斯氏针，用于控制，并作为假体置入过程中验证假体旋转角度的导向。
