PMC5458699_01
Pre-operative radiograph of 75 years male patient with garden type 3 neck of femur fracture and for whom above-knee amputation was done.
JOCR-7-54-g001.jpg
PMC5458699_01_JOCR-7-54-g001.jpg
F1
OTA 33.C3 distal femur and Gustilo type 3B open OTA 42.C1.2 both bones leg fracture of right lower limb and with ipsilateral OTA 31.B2.1 of Garden type 3 neck of femur fracture (Fig. 1). On examination, he was drowsy and found to be hemodynamically unstable.
Per-operative picture showing the Schanz pin placement. Two 6.5 mm Schanz pins have been applied perpendicular to each other with one pin in anteroposterior plane and the second pin in saggital plane just proximal to the amputation stump.
JOCR-7-54-g002.jpg
PMC5458699_01_JOCR-7-54-g002.jpg
F2
Initially, as the first step two 6.5 mm Schanz pins have been applied perpendicular to each other with one pin in anteroposterior plane and the second pin in saggital plane (Fig. 2 and 3) with an idea that this will aid in traction and also manipulating the femur which is difficult in such cases.
Fluoroscopic images showing the pin placement.
JOCR-7-54-g003.jpg
PMC5458699_01_JOCR-7-54-g003.jpg
F3
Initially, as the first step two 6.5 mm Schanz pins have been applied perpendicular to each other with one pin in anteroposterior plane and the second pin in saggital plane (Fig. 2 and 3) with an idea that this will aid in traction and also manipulating the femur which is difficult in such cases.
Fluoroscopic images showing proper placement of the prosthesis.
JOCR-7-54-g004.jpg
PMC5458699_01_JOCR-7-54-g004.jpg
F4
Position was verified on fluoroscopy (Fig. 4 and 5) and intraoperative stability confirmed.
Fluoroscopic images showing well seated stem.
JOCR-7-54-g005.jpg
PMC5458699_01_JOCR-7-54-g005.jpg
F5
Position was verified on fluoroscopy (Fig. 4 and 5) and intraoperative stability confirmed.
One-year follow-up radiograph.
JOCR-7-54-g006.jpg
PMC5458699_01_JOCR-7-54-g006.jpg
F6
Now at 14 months, the patient is comfortable, pain-free and walking full weight bearing without any support (Fig. 6).