Femoral neck fractures in patients with prior lower-limb amputation: a two-case series and narrative review of surgical decision-making.
- 1Department of Orthopedics, Fuyang People's Hospital Affiliated to Anhui Medical University, Fuyang, Anhui, China.
- 2Department of Orthopedics, Clinical Research Center for Spinal Deformity of Anhui Province, Fuyang, Anhui, China.
Abstract
Background
Femoral neck fractures in patients with pre-existing lower-limb amputation are rare clinical conditions that pose unique technical challenges and surgical decision-making dilemmas for orthopedic surgeons. Altered hip biomechanics, reduced bone mineral density, and dependence on prosthetic ambulation complicate preoperative planning and postoperative rehabilitation, and no unified therapeutic consensus has been established in clinical practice ( 1- 5).Case presentation
We report two distinct clinical cases of femoral neck fractures in amputees managed with different surgical strategies. The first patient was a 55-year-old male with ipsilateral transfemoral amputation who sustained a minimally-displaced Garden II femoral neck fracture and underwent closed reduction combined with cannulated compression screw (CCS) internal fixation. The second patient was a 70-year-old male who experienced left transtibial amputation in a mining accident in 1984; he sustained a fully-displaced Garden IV femoral neck fracture and received primary total hip arthroplasty (THA).Total follow-up was 12 months for Case 1 and 6 months for Case 2. Both patients achieved satisfactory short-term functional recovery, with validated functional scores recorded at final follow-up, and no major perioperative complications occurred.Conclusions
This two-case series combined with a narrative review highlights the need for individualized surgical strategies for amputees with femoral neck fractures. Based on our limited clinical observations, internal fixation may be suitable for younger patients with minimally-displaced fractures and preserved pre-injury hip function, whereas THA may yield favorable functional outcomes in elderly patients with completely-displaced fractures. The proposed treatment algorithm should be regarded only as experience-based guidance rather than universal clinical recommendations.
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BibTeX
@article{li2026femoral,
title = {{Femoral neck fractures in patients with prior lower-limb amputation: a two-case series and narrative review of surgical decision-making.}},
author = {Dan Li and Haiyang Yu and Wanrong Yang},
journal = {Frontiers in surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1949434},
url = {https://europepmc.org/article/MED/42909085},
note = {CC BY},
}
RIS
TY - JOUR
TI - Femoral neck fractures in patients with prior lower-limb amputation: a two-case series and narrative review of surgical decision-making.
AU - Dan Li
AU - Haiyang Yu
AU - Wanrong Yang
PY - 2026
DA - 2026/10/07
JO - Frontiers in surgery
DO - 10.3389/fsurg.2026.1949434
UR - https://europepmc.org/article/MED/42909085
AB - Background Femoral neck fractures in patients with pre-existing lower-limb amputation are rare clinical conditions that pose unique technical challenges and surgical decision-making dilemmas for orthopedic surgeons. Altered hip biomechanics, reduced bone mineral density, and dependence on prosthetic ambulation complicate preoperative planning and postoperative rehabilitation, and no unified therapeutic consensus has been established in clinical practice ( 1- 5).Case presentation We report two distinct clinical cases of femoral neck fractures in amputees managed with different surgical strategies. The first patient was a 55-year-old male with ipsilateral transfemoral amputation who sustained a minimally-displaced Garden II femoral neck fracture and underwent closed reduction combined with cannulated compression screw (CCS) internal fixation. The second patient was a 70-year-old male who experienced left transtibial amputation in a mining accident in 1984; he sustained a fully-displaced Garden IV femoral neck fracture and received primary total hip arthroplasty (THA).Total follow-up was 12 months for Case 1 and 6 months for Case 2. Both patients achieved satisfactory short-term functional recovery, with validated functional scores recorded at final follow-up, and no major perioperative complications occurred.Conclusions This two-case series combined with a narrative review highlights the need for individualized surgical strategies for amputees with femoral neck fractures. Based on our limited clinical observations, internal fixation may be suitable for younger patients with minimally-displaced fractures and preserved pre-injury hip function, whereas THA may yield favorable functional outcomes in elderly patients with completely-displaced fractures. The proposed treatment algorithm should be regarded only as experience-based guidance rather than universal clinical recommendations.
SN - 2296-875X
ER -