{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:24:39Z","timestamp":1784892279827,"version":"3.55.0"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"4","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>The management of retained orthopedic hardware during amputation procedures presents significant challenges. A case utilizing a modified Gritti-Stokes through-knee amputation to address a periprosthetic fracture with an exposed intramedullary nail (IMN) in a patient with multiple comorbidities is reported. A 47-year-old male with a history of human immunodeficiency virus, hepatitis C virus, and type 2 diabetes mellitus presented with a left femoral periprosthetic supracondylar fracture. The patient had an existing IMN from a previous femoral shaft fracture 20 years prior, along with a left below-knee amputation. Due to the newly occurred periprosthetic fracture and the patient\u2019s immunocompromised status, further amputation was deemed necessary. However, removal of the well-integrated IMN posed significant risks. A modified Gritti-Stokes through-knee amputation was performed, adapting the procedure to use the patella as a biological cap to cover the exposed IMN tip. At 4-month follow-up, the patient demonstrated satisfactory wound healing and stable positioning of the patellar cap. The patient achieved ambulation with an above-knee prosthesis and crutch assistance, reporting high satisfaction and no pain or discomfort. This case highlights the versatility of the Gritti-Stokes procedure in addressing complex scenarios involving retained hardware. By utilizing the patella as a biological cover for the exposed IMN, the risks associated with hardware removal was avoided while achieving a stable, well-healed amputation stump. This modification of the Gritti-Stokes technique o!ers a viable solution for patients with retained IMNs requiring through-knee amputation, particularly in cases where hardware removal is contraindicatedor highly risky.\r\n\u00a0\r\nCite this article as: Tseng H, Chien C, Wu T. Modified Gritti-Stokes amputation for periprosthetic fracture with irremovable femoral nail: case report and review of an overlooked procedure. Acta Orthop Traumatol Turc., 2025;59(4):232-236.<\/jats:p>","DOI":"10.5152\/j.aott.2025.24213","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T04:00:22Z","timestamp":1749700822000},"page":"232-236","source":"Crossref","is-referenced-by-count":2,"title":["Modified Gritti-Stokes amputation for periprosthetic fracture with irremovable femoral nail: case report and review of an overlooked procedure"],"prefix":"10.5152","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-4851","authenticated-orcid":false,"given":"Han-Po","family":"Tseng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7880-3282","authenticated-orcid":false,"given":"Chi-Sheng","family":"Chien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0540-6283","authenticated-orcid":false,"given":"Tsung-Mu","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3111","published-online":{"date-parts":[[2025,6,5]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/4017\/3955","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/4017\/3955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:11:50Z","timestamp":1763457110000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/4017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,5]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,7,18]]}},"URL":"https:\/\/doi.org\/10.5152\/j.aott.2025.24213","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"value":"2589-1294","type":"electronic"},{"value":"1017-995X","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6,5]]}}}