Aims: Operative treatment of trochanteric fractures in patients with below knee amputation on the same limb is a rare and challenging problem. This is difficult not only because of the absence of foot but also due to coexisting medical problems. The aim of this study was to analyse the problems involved in the treatment of this rare problem. Methods: We reviewed 13 such patients being treated at East kent Hospital Trust over 7 years between Nov 1993 and Dec 2000 constituting less than. 026% of total fracture neck of femur patients. All patients were treated by DHS fixation. Six of these had Reverse boot traction applied during surgery and seven of these had upper tibial pin traction. Results: We observed that boot traction is easy and quick method with less complications. Also these patients rehabilitated better than pin traction group. They started using their prosthesis in 3 days as compared to 7 days in pin traction group. Patients in whom Reverse boot technique was used were discharged home earlier (in 14 days as compared to 21 days) than patients who had pin traction applied during surgery. Results: Although this study included a very small number of patients but it is a largest of its type. Based on our results we recommend that reverse boot traction should be used in all such patients.

Aims: Operative treatment of trochanteric fractures in patients with below knee amputation on the same limb is a rare and challenging problem. This is difficult not only because of the absence of foot but also due to coexisting medical problems. The aim of this study was to analyse the problems involved in the treatment of this rare problem.

Methods: We reviewed 13 such patients being treated at East kent Hospital Trust over 7 years between Nov 1994 and Dec 2001 constituting less than .026% of total fracture neck of femur patients. All patients were treated by DHS fixation. Six of these had Reverse boot traction applied during surgery and seven of these had upper tibial pin traction.

Results: We observed that boot traction is easy and quick method with less complications. Also these patients rehabilitated better than pin traction group. They started using their prosthesis in 3 days as compared to 7 days in pin traction group. Patients in whom Reverse boot technique was used were discharged home earlier (in 14 days as compared to 21 days) than patients who had pin traction applied during surgery.

Results: Although this study included a very small number of patients but it is a largest of its type. Based on our results we recommend that reverse boot traction should be used in all such patients.