Surgical Tips: Managing the Orthopedic Traction Table on Gritti-Stokes Amputated Patients

Abstract

Introduction: Closed anatomical reduction of per-trochanteric fractures requires 3-axis control of the orthopedic traction table (OTT) which is challenging in patients having suffered a previous ipsilateral Gritti-Stokes amputation.

Case report: A 52-year-old man, known by Gritti-Stokes amputated (GSA) 10 years before, was admitted to our trauma center after a fall from his height. We describe a simple method for positioning a previously ipsilateral GSA patient in an OTT to reduce displaced a femoral per-trochanteric fracture site and to maintain it during surgery. The proposed method attaches non-adhesive bands to the stump, reinforced by the wire guide package to increase rigidity and allow 3-axis control of the OTT.

Conclusion: This method can be performed in a standard trauma operating room, it only uses materials that were planned to be used during surgery, and consequently, it does not increase operative costs.

Keywords: Gritti-Stokes amputation; orthopedic traction table; orthopedic trauma; patient positioning; per-trochanteric femoral fracture.

Figure 1

Pelvis anterior to posterior radiography showing a 31-A1 per-trochanteric fracture, according to AO/OTA.

Figure 2

(A) Pre-operative axial hip radiography; (B) Post-operative axial hip radiography.

Figure 3

(a) Post-operative proximal femur anterior to posterior (AP) radiography; (b) Post-operative distal femur AP radiography.

Figure 4

Patient’s positioning – lateral view.

Figure 5

Patient’s positioning – distal view.

Figure 6

Stryker T2® ball-tipped Ø3 × 1000 mm wire guide’s package.

Figure 7

Stump after surgery.