Management and Outcomes of Hip Fractures in Lower Limb Amputees: A Case Series

Abstract

Background: Hip fractures in amputees pose a significant challenge for the orthopedic surgeon due to technical difficulties and there is no standardisation in their management. Their treatment is consequently left to the surgeon’s ingenuity. The aim of this study is to describe the clinical characteristics and outcome of a series of hip fractures in lower limb amputees. Methods: A total of 12 patients and 15 hip fractures in lower limb amputees were included. Amputations below the malleoli and prosthetic surgery due to osteoarthritis constitute the exclusion criteria. Demographic, amputation-related and fracture data as well as radiological, functional, and clinical outcomes were collected through the patients' medical records. Results: Age at fracture and at amputation were different depending on the cause of amputation. Most patients (10/12) were male. Seven patients had an infracondylar amputation and five patients had a supracondylar amputation. Ten hip fractures were on the same side of the amputation, three were contralateral and one was bilateral. Pertrochanteric (6/15) and subcapital (5/15) were the main types observed. Different traction methods and surgical procedures were used. We observed no significant differences in terms of outcome regardless of the fracture, traction method, and surgical management. No complications related to surgery or during follow-up were found. Mortality at one year postoperatively was absent. Conclusion: Provided an experienced orthopaedic surgeon, a pre-operative assessment, a comprehensive surgical planning, and a multidisciplinary rehabilitation strategy are present; a satisfactory outcome is to be expected.