Introduction: An intertrochanteric fracture (IT) with below-knee (BK) amputation is challenging to manage since it is impossible to provide the ideal amount of traction to reduce the fracture due to the lack of a foot. We emphasize this complex problem and offer solutions to overcome it. Case Presentation: A 55-year-old man with a previous ipsilateral BK amputation presented to us after an episode of fall. The patient had been using a BK prosthesis for mobilization before the fall. Radiographs revealed a femoral IT fracture. A proximal femoral nail (PFN) fixation was intended for the fracture, but positioning the patient on the fracture table for surgery proved challenging. The patient had to be carefully positioned on the fracture table during surgery. Conclusion: The reverse boot technique is an effective method for treating an IT fracture in a patient with ipsilateral BK amputation. It involves the usual technique of applying traction, achieving reduction, and fixing the fracture with a PFN of the appropriate size. The patient was able to walk with support the next day after surgery and pre-injury mobility was regained within 3 days. We here emphasize a method of applying traction with this simple modification of the fracture table to apply an adequate amount of traction safely. Keywords: Fracture table, intertrochanteric fracture, below-knee amputation.

Introduction: Avulsion tuberosity fracture of the calcaneus is relatively unusual and occurs more frequently in elderly osteoporotic patients. Direct trauma to the heel is a rare cause in young individuals. Failure to perform early open reduction and internal fixation (ORIF) potentially leads to soft-tissue complications due to pressure necrosis of the overlying skin. Case Presentation: A 29-year-old male patient experienced left heel pain with swelling after the assault as he was hit by an iron rod 8 days prior. Radiographs revealed a Beavis Type 2 calcaneal avulsion fracture. An open reduction with two corticocancellous (CC) screw fixation was intended for the fracture. Conclusion: The avulsed bone fragment was small causing difficulty in reduction. The result of closed reduction in such a scenario is not promising and usually requires ORIF. We performed a modified surgical procedure of CC screw fixation in which one screw was passed perpendicular to the fracture plane for reduction of the fracture and another screw was passed obliquely to nullify Achilles forces. We believe that this technique of fracture management improves patient outcome and early mobilization. Keywords: Avulsion, calcaneus fracture, corticocancellous screw fixation, CC screw, tuberosity fracture.