title: Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique.
abstract: While neck of femur fractures are common it is rare to see this injury in a bilateral leg amputee. Special consideration needs to be given to the management of these patients. We report the case of a 58-year-old man with bilateral leg amputation who presented to the emergency department with left hip pain following a fall. A fracture of the left neck of femur with extension into the femoral shaft was diagnosed. Internal fixation was planned with a dynamic hip screw. Standard fracture table setup, which allows for traction of the fractured limb and positioning of the contralateral limb such that anteroposterior and lateral X-rays can be obtained, was not possible in this case due to the amputations. We highlight considerations that need to be made in positioning a bilateral amputee for neck of femur fracture fixation and also highlight an improvised technique that can be utilised by other surgeons.
authors.affiliation: Department of Trauma and Orthopaedics, North Tees and Hartlepool NHS Foundation Trust, Stockton on Tees, UK.
authors.forename: Andrew James
authors.initials: AJ
authors.lastname: Berg
authors.forename: Chandra
authors.initials: C
authors.lastname: Bhatia
mesh_terms: D000674:Amputees; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058638:Operating Tables; D056888:Patient Positioning / Q000379:methods*; D014143:Traction / Q000379:methods*