School of Medicine Publications
Document Type
Article
Publication Date
3-20-2026
Abstract
Introduction:Total femur replacement (TFR) is a salvage procedure for patients with multiple failed hip and knee arthroplasties and is associated with high complication rates. Intramedullary TFR has emerged as a technique to preserve critical soft tissue attachments; however, maintaining limb length, alignment, and rotation remains challenging.
Case Presentation: We describe a novel case of intramedullary TFR utilizing external fixation to address these technical challenges. A 64-year-old male with subsidence of a hinged knee tumor prosthesis to the level of the greater trochanter underwent intramedullary TFR. External fixation was applied to the residual femoral and tibial bones to maintain limb length, alignment, and rotation during revision knee arthroplasty and total hip arthroplasty. At 1-year follow-up, the patient demonstrated improved function without complication or infection.
Conclusion: Based on this case report, intramedullary TFR utilizing external fixation can be used to maintain critical aspects of the limb, such as neurovascular structures, soft tissues, and positioning the lower extremity, therefore easing many of the technical challenges of the procedure. This may allow for fewer surgical complications as the difficulty of the procedure is eased and better patient outcomes as the procedure may be completed with more precision.
Recommended Citation
Hnatow, M., Martin, B. C., & Herrera, E. (2026). External Fixation Assisted Intramedullary Total Femur Arthroplasty: A Case Report. Case Reports in Surgery, 2026(1), 8636493. https://doi.org/10.1155/cris/8636493
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
Case Reports in Surgery
DOI
https://doi.org/10.1155/cris/8636493
Academic Level
medical student
Mentor/PI Department
Surgery
Comments
Copyright © 2026 Matthew Hnatow et al. Case Reports in Surgery published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.