Tailoring the approach: Management of femur fractures in post-polio syndrome patients.

Background: Post-polio syndrome (PPS) can significantly alter lower limb anatomy and function. Femur is the most commonly fractured bone in post-polio patients. This study aimed to investigate the surgical challenges, fixation techniques employed, and functional outcomes in PPS patients with femoral fractures. Methods: A retrospective analysis was conducted on 38 PPS patients diagnosed with femoral fractures. We assessed the underlying injury mechanism, anatomical variations (e.g., valgus neck deformity, hypoplastic greater trochanter, narrow canal, fixed knee flexion), and employed fixation techniques. Union time and functional recovery were evaluated. Results: Trivial falls were the most frequent cause of fracture. Notably, various anatomical variations were observed, potentially influencing treatment strategies. Intramedullary nailing was the preferred fixation method; however, some cases necessitated alternative extramedullary fixation techniques due to anatomical constraints. The average time for fracture union was 24 weeks, with all patients regaining their pre-fracture functional status. Conclusion: Femoral fracture management in PPS patients requires meticulous consideration of unique anatomical challenges and patient-specific factors. A multidisciplinary approach emphasizing preoperative planning, intraoperative adaptability in fixation techniques, and comprehensive postoperative rehabilitation is crucial for optimal outcomes and minimizing complications.