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高位膝上截肢患者的股骨转子间骨折:术中规划与植入物选择的技术要点及文献综述

Intertrochanteric Femur Fracture in a High-Above-Knee Amputee: Technical Tips for Intraoperative Planning and Implant Selection with Literature Review.

作者信息

Kantiwal Prabodh, Aggarwal Aakarsh, Nemani Sugandhi, Yadav Sandeep Kumar, Banerjee Sumit

机构信息

Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Department of Anaesthesia, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

出版信息

J Orthop Case Rep. 2025 Sep;15(9):305-311. doi: 10.13107/jocr.2025.v15.i09.6108.

Abstract

INTRODUCTION

Intertrochanteric (IT) fractures are rarely reported in amputation stumps.

CASE REPORT

This report presents the case of an elderly male with a right above-knee amputation who sustained an ipsilateral IT fracture. He had undergone amputation 3 years prior and was mobilizing independently with a prosthetic limb. The current injury occurred due to the rollover of a four-wheeler in which he was traveling. A proximally sized femoral nail was selected for fracture fixation, with the goal of internal splinting across the entire residual femoral length. Postoperatively, the patient resumed use of his previous prosthesis without difficulty.

CONCLUSION

Treatment goals in such cases should include preservation of stump length, avoidance of prosthesis socket revision, prevention of peri-implant fractures and implant failure, and the use of load-sharing implants in the lower extremity stump. In addition, enabling the patient to return to their prior level of activity should be a key therapeutic objective.

摘要

引言

粗隆间骨折在截肢残端中鲜有报道。

病例报告

本报告介绍了一名老年男性患者,该患者右膝上截肢,同侧发生粗隆间骨折。他在三年前接受了截肢手术,当时正借助假肢独立活动。此次受伤是由于他乘坐的四轮车侧翻所致。选择了近端尺寸合适的股骨钉进行骨折固定,目的是在整个残余股骨长度上进行内固定。术后,患者顺利恢复使用先前的假肢。

结论

此类病例的治疗目标应包括保留残端长度、避免假肢接受腔翻修、预防植入物周围骨折和植入物失效,以及在下肢残端使用分担负荷的植入物。此外,使患者恢复到先前的活动水平应是关键的治疗目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ef4/12422670/e1b7cc139afd/JOCR-15-305-g001.jpg

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