Stump fractures in lower extremity amputees.

Area of Science:

• Orthopedics
• Trauma Surgery
• Rehabilitation Medicine

Background:

• Lower extremity fractures can occur in amputees.
• These fractures present unique challenges in diagnosis and management.

Purpose of the Study:

• To evaluate the nature, associated problems, and treatment outcomes of ipsilateral lower extremity fractures in above-knee and below-knee amputees.
• To determine the incidence and impact of these fractures on amputee rehabilitation.

Main Methods:

• Qualitative evaluation of 23 above-knee and below-knee amputees with ipsilateral lower extremity fractures.
• Review of injury characteristics, diagnostic timelines, treatment modalities, and functional outcomes.

Main Results:

• Fractures occurred in 3% of lower extremity amputees, involving distal femur and hip.
• Over 25% of fractures had delayed diagnosis.
• Femur fractures were mostly treated nonoperatively; hip fractures operatively.
• Dysvascular amputees had the poorest rehabilitation outcomes, with 50% of former household ambulators remaining wheelchair-bound.

Conclusions:

• Lower extremity fractures in amputees are infrequent but associated with significant morbidity.
• Delayed diagnosis is a common issue.
• Dysvascular status is a critical factor influencing post-fracture functional recovery in amputees.