26dkou489 10.3205/26dkou489 urn:nbn:de:0183-26dkou4896 Meeting Abstract Vadgaonkar Vadgaonkar Aditya A

Universitätsmedizin Mannheim, Mannheim, Deutschland

author Hackl Hackl Michael M

Universitätsmedizin Mannheim, Mannheim, Deutschland

author Gravius Gravius Sascha S

Universitätsmedizin Mannheim, Mannheim, Deutschland

author Darwich Darwich Ali A

Universitätsmedizin Mannheim, Mannheim, Deutschland

author Blümke Blümke Alexander A

Universitätsmedizin Mannheim, Mannheim, Deutschland

author Eschmann Eschmann David D

Universitätsmedizin Mannheim, Mannheim, Deutschland Krankenhaus Hetzelstift, Neustadt an der Weinstraße, Deutschland

author Bludau Bludau Frederic F

Universitätsmedizin Mannheim, Mannheim, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 489 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Poster | Osteologie, Alterstraumatologie und Wirbelsäule Berlin 20261020 20261023 DKOU26_Abs_994 TextObjectives and questions: Pertrochanteric femur fractures in patients with ipsilateral above-knee amputations present unique challenges, as the use of standard reduction techniques such as traction tables is impractical. Modified techniques, including the use of K-wires, Schanz pins, or bone clamps, are often invasive and carry the risk of vascular disruption and surgical site infections. Given these limitations, we developed a non-invasive technique that leverages the cephalomedullary nail as a joystick to reduce the fracture.Material and methods: Patients with a history of ipsilateral above-knee amputation who subsequently sustained a pertrochanteric femur fracture were treated using the novel technique at our institution between January 2019 and January 2024. Radiological outcomes in these patients were evaluated by assessing fracture reduction quality according to Schipper et al. and fixation quality using the Cleveland and Bosworth quadrant system.Results: Between January 2019 and January 2024, three patients (two males, mean age 84 ± 11 years) with an ipsilateral above-knee amputation were treated using the novel technique with a cephalomedullary nail using TFN-Advanced™ Proximal Femoral Nailing System or PFNa, Proximal Femur Nail Antirotation (DePuySynthes, Johnson & Johnson MedTech). These patients had a mean Charlson Comorbidity Index of 10 ± 2.1. Radiological evaluation showed anatomic reduction in two cases and acceptable reduction in one, with optimal femoral neck fixation in two cases. The mean operative time and hospital stay were 89 ± 100 min and 18 ± 15 days respectively. No surgery-related complications occurred, and all patients were mobilised with full weight-bearing using their exoprostheses.Discussion and conclusions: This novel technique provides a safe alternative for fracture reduction in amputees, avoiding the risks associated with invasive hardware. It offers advantages such as minimal soft tissue disruption, which might subsequently improve patient outcomes. Further studies with larger cohorts are necessary to validate its efficacy and determine its broader applicability in clinical practice. 0 0 0 0