Femoral fractures in patients with lower extremity amputations.

Femoral fracture in patients with lower extremity amputations is relatively rare (reported incidence in 341 amputee patients, 2.35%). Lack of adequate support and balance, and osteoporosis on the amputation side, may explain the predisposition to fracture of the ipsilateral extremity. The prosthesis was in use at the time of the accident in only 3 of 9 cases studied, most falls occurring during transfer activity without a prosthesis. Proximal femoral fractures in below-knee amputee patients responded to open reduction with internal fixation and early ambulation. Others were treated with closed reduction and cast immobilization. Overall union was 100%, with all patients regaining their previous ambulatory levels and prosthesis skills.