Primary Total Hip Replacement in the Lower Limb Amputees

Hwang, Sung Kwan; Park, Kee Young

Abstract

Femoral fracture, dislocation of the hip, or tasumatic amputation of the ipsilateral lower extremity is a rare injury. There has been only a few reports describing their managements. All amputated limbs are vulnerable to fracture, which occur frequently around the hip. Conservative treatments are not always adequate for the managements of fracture and dislocation of the hip and operative procedures are needed in almost patients. Among various operative measures, prosthetic replacement surgery may be indicated in cases of non-united fracture of the femoral neck, avascular necrosis of the femoral head, pathological fracture, or osteoporosis. We performed two cases of total hip replacement for the non-united fracture of the femoral neck(case 1) and the avascular necrosis of the femoral head(case 2) in the ipsilateral lower limb amputees, each. The early results were known to be very satisfactory postoperatively. The first patient was followed for 17 months and the second patient for 22 months. 1. P.C.A. femoral stems and acetabular cups were used without cement in both cases. A operative time was 2 hours and 22 minutes in the first case, 1 hour 45 minutes. in the second case. 2. There were no significant intraoperative or postoperative complications. 3. The functions of each hip were evaluated postoperatively by the method of Jesse and showed satisfactory results. 4. During the follow-up period, roentgenogram showed no significant bony changes around the femoral stems and acetabular cups. 5. The prosthetic replacement is also valuable for the treatment of the fracture-dislocation of the hip in the lower limb amputee.