Management of an Ipsilateral Intertrochanteric Fracture in a Below-Knee Amputee: A Case Report Highlighting a Novel Modification of the Inverted Boot Technique
Gowtham Krishna Y*, Reuben Cedric Nappoly and Paulson Varghese
ABSTRACT
Managing intertrochanteric (IT) fractures in below-knee (BK) amputees is challenging, as standard fracture table techniques rely on an intact foot for traction. The inverted boot technique provides a non-invasive alternative, but its success depends on the residual limb length. We present a case of a 62-year-old woman with a left BK amputation and IT fracture. The standard inverted boot method was unsuccessful due to her short stump. The team modified the setup by angling the fracture table’s traction arm to 90°, enabling secure traction and successful fixation with a proximal femoral nail (PFN). At 12 weeks, the patient was fully weight-bearing with radiographic healing. This cost-free, simple modification broadens the applicability of the inverted boot technique in amputees with short stumps.
