Lineham, B, Harwood, P and Giannoudis, P (2017) Successful management of femoral trauma in a through-knee amputee with a previous malunited fracture: Implications and functional outcome. Prosthetics and Orthotics International, 41 (5). pp. 512-516. ISSN 0309-3646
Abstract
Background: After amputation patients are more likely to injure their residual limb. An injury of a previously amputated limb, especially if the residuum is not anatomically normal, poses a dilemma for management.
Case Description and Methods: This case report discusses a femoral fracture sustained proximal to a through-knee amputation.
Findings and outcomes: The fracture was at the site of a malunited fracture. A shortening osteotomy with bone graft was undertaken to improve alignment and prosthetic fit and remove poor-quality bone. This was stabilised using an intramedullary nail, supplemented with an anti-rotation plate. This fracture went on to uneventful union, and the patient was able to comfortably use a prosthesis with increased functionality compared with prior to the recent injury.
Discussion: This management enabled quick healing of the fracture without the need to resort to a more proximal amputation.
Conclusion: In these unusual cases, careful planning is necessary to ensure all aspects of the problem is dealt with. Each case should be treated on its own merits.
Clinical relevance: This case demonstrates the difficulty in care of complex limb trauma and offers a solution for management of similar cases. Excellent results are possible when all surgical options are considered.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Femur; amputation; osteotomy; diamond concept; prosthesis |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Orthopaedics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 23 Oct 2018 09:04 |
Last Modified: | 23 Oct 2018 09:04 |
Status: | Published |
Publisher: | SAGE |
Identification Number: | 10.1177/0309364616683821 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:137571 |