Skin traction for reduction of a cervico-trochanteric fracture with below-knee amputation and knee stiffness: a case report

Trochanteric fractures and positioning for their surgical treatment pose a difficult problem when encountered in patients with below-knee amputations. We present a case of a 60-year old gentleman with a below-knee amputation on his left who was the victim of a traffic accident. The patient is a war veteran who was the victim of a traumatic left below-knee amputation 30 years ago following a land-mine injury. Radiographs of his pelvis is consistent with a minimally displaced cervico-trochanteric fracture of the left hip. He had a stiff knee. The surgical treatment by closed reduction on a radiolucent fracture table and internal fixation using short femoral nail was performed. We used an adhesive bandage to strap the below knee stump of the affected limb to the boot of the traction table. The reduction and the position of the nail were satisfactory. After three months, the patient could walk with full weight bearing using a prosthesis on his affected limb. The skin traction method is simple and allows achieving and maintaining safe reduction during fixation especially in patients with limited range of motion of the knee.