{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:29:05Z","timestamp":1787027345716,"version":"build-2736575974"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Femoral neck fractures in transfemoral amputees are rare, and their management remains controversial, particularly in individuals with short residual limb lengths. Traditional approaches to total hip arthroplasty (THA), such as the anterolateral, Hardinge, and posterior methods, present significant challenges, including difficulties in residual limb manipulation, femoral exposure, and postoperative swelling. The direct anterior approach (DAA), a minimally invasive technique, has not been previously reported for THA in this patient population. This case report aims to evaluate the feasibility and outcomes of the DAA for THA in a transfemoral amputee with a femoral neck fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present the case of a 64-year-old Han male with an ipsilateral transfemoral amputation who sustained a femoral neck fracture. The patient underwent THA using the direct anterior approach. The DAA was selected due to its minimally invasive nature and ability to navigate through the intermuscular interval, which facilitated improved manipulation of the residual limb and easier exposure of the femoral side. Standard surgical protocols were followed, and postoperative care included monitoring for complications such as infection, thrombosis, and dislocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient's postoperative recovery was uneventful, with no signs of infection, thrombosis, dislocation, or other complications. Notably, there was no significant residual limb swelling, which was attributed to the minimally invasive nature of the DAA. The patient achieved unrestricted hip mobility without postural restrictions and attained a Harris Hip Score of 84.78 at follow-up, indicating a favorable functional outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case demonstrates the efficacy and safety of the direct anterior approach for total hip arthroplasty in patients with high above-knee amputations. The DAA effectively addresses many challenges associated with traditional approaches, such as residual limb manipulation, femoral exposure, and postoperative swelling. These findings suggest that the DAA is a viable alternative for managing femoral neck fractures in transfemoral amputees, warranting further investigation in larger studies to validate its broader applicability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1556599","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T03:03:04Z","timestamp":1742266984000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Total hip arthroplasty, through the direct anterior approach, for a femoral neck fracture of ipsilateral transfemoral amputee: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Xiangde","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gangliang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1097\/BOT.0000000000000291","article-title":"Femoral neck fractures: current management","volume":"29","author":"Florschutz","year":"2015","journal-title":"J Orthop Trauma"},{"key":"B2","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1016\/j.apmr.2007.11.005","article-title":"Estimating the prevalence of limb loss in the United States: 2005\u20132050","volume":"89","author":"Ziegler-Graham","year":"2008","journal-title":"Arch Phys Med Rehab"},{"key":"B3","doi-asserted-by":"publisher","first-page":"50","DOI":"10.22551\/2022.35.0902.10203","article-title":"Total hip arthroplasty for an intracapsular femoral neck fracture of high-femoral amputee","volume":"9","author":"Christidis","year":"2022","journal-title":"Arch Clin Cases"},{"key":"B4","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1177\/112070001002000424","article-title":"Total hip arthroplasty in a patient with arthrogryphosis and an ipsilateral above knee amputation","volume":"20","author":"Leonard","year":"2010","journal-title":"Hip Int"},{"key":"B5","doi-asserted-by":"publisher","first-page":"593747","DOI":"10.1155\/2015\/593747","article-title":"Hip arthroplasty in a patient with transfemoral amputation: a new tip","volume":"2015","author":"Boussakri","year":"2015","journal-title":"Case Rep Orthop"},{"key":"B6","doi-asserted-by":"publisher","first-page":"104","DOI":"10.5301\/hipint.5000001","article-title":"Total hip arthroplasty following an ipsilateral above knee amputation","volume":"23","author":"Diamond","year":"2013","journal-title":"Hip Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.1007\/s00264-016-3125-3","article-title":"Total hip arthroplasty via the anterior approach: tips and tricks for primary and revision surgery","volume":"40","author":"York","year":"2016","journal-title":"Int Orthop"},{"key":"B8","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1302\/0301-620X.99B6.38053","article-title":"The direct anterior approach in total hip arthroplasty: a systematic review of the literature","author":"Meermans","year":"2017","journal-title":"Bone Joint J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e255085","DOI":"10.1136\/bcr-2023-255085","article-title":"Simultaneous above-knee amputation and ipsilateral total hip arthroplasty in a neglected neck of femur fracture with an insensate limb","volume":"16","author":"Tripathy","year":"2023","journal-title":"BMJ Case Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/1749-799X-4-30","article-title":"Bipolar hip hemiarthroplasty in a patient with an above knee amputation: a case report","volume":"4","author":"Kandel","year":"2009","journal-title":"J Orthop Surg Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.arth.2024.02.039","article-title":"Outcomes following intraoperative Calcar fractures during cementless total hip arthroplasty","volume":"39","author":"Wilson","year":"2024","journal-title":"J Arthroplasty"},{"key":"B12","doi-asserted-by":"publisher","first-page":"105848","DOI":"10.1016\/j.clinbiomech.2022.105848","article-title":"Cerclage wire or positional cortical screw for the treatment of intraoperative calcar fractures during primary total hip arthroplasty? A biomechanical study","volume":"101","author":"Gauthier","year":"2023","journal-title":"Clin Biomech"},{"key":"B13","doi-asserted-by":"publisher","first-page":"3981","DOI":"10.12998\/wjcc.v10.i13.3981","article-title":"Amputation stump management: a narrative review","volume":"10","author":"Choo","year":"2022","journal-title":"World J Clin Cases"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1556599\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T03:03:06Z","timestamp":1742266986000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1556599\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":13,"alternative-id":["10.3389\/fsurg.2025.1556599"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1556599","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]},"article-number":"1556599"}}