Dynamic Hip Screw Fixation of a Proximal Femur Fracture in a Patient With Ipsilateral Above-Knee and Contralateral...

Intertrochanteric hip fractures are usually managed with dynamic hip screw (DHS) fixation, but standard positioning and traction are difficult in patients with major lower-limb amputations. We describe a 77-year-old woman with a right above-knee amputation and no contralateral limb who sustained an intertrochanteric fracture after a wheelchair fall. The main challenge was achieving axial traction and rotational control on a very short femoral stump without damaging it or compromising imaging. We achieved closed reduction by inserting a distal femoral Steinmann pin and attaching a stirrup to apply controlled traction and rotation on the fracture table, followed by standard DHS fixation through a lateral approach. The patient returned to her pre-injury level of bed-to-wheelchair transfers, and this case outlines a reproducible positioning and traction strategy for similar complex presentations. This case highlights a reproducible skeletal traction strategy that provides safe imaging corridors and controlled reduction even in the absence of the contralateral limb.