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Turn-up bone flap for lengthening the below-knee amputation stump
The Journal of Bone and Joint Surgery. British Volume
|April 8, 2003
Summary
A surgical technique uses the distal tibia or foot to lengthen short tibial stumps, preserving the knee joint for below-knee prosthesis use in amputations. This method is ideal for well-vascularized distal legs, enabling successful limb reconstruction.
Area of Science:
- Orthopedic Surgery
- Limb Reconstruction
- Trauma Surgery
Background:
- Amputation below the knee due to extensive tibial bone or soft tissue loss (tumors, fractures, infection) can result in a proximal tibial stump too short for standard prosthetics.
- A normal knee joint is often preserved, but a short stump prevents effective prosthetic fitting, impacting patient mobility and quality of life.
Observation:
- A novel surgical approach involves incorporating the distal tibia or foot into a long posterior flap by rotating it proximally.
- This technique effectively lengthens very short proximal tibial stumps, even when conventional methods are insufficient.
Findings:
- The described flap technique successfully increased the length of the proximal tibial stump in five procedures.
- This allows for the satisfactory use of a below-knee prosthesis, preserving knee function.
Implications:
- This reconstructive surgery offers a viable solution for patients with extremely short tibial stumps, avoiding more extensive amputations.
- It enhances prosthetic fitting and functional outcomes, particularly in cases with a healthy and well-vascularized distal leg.
- The technique holds promise for improving limb salvage rates and patient rehabilitation after complex lower leg injuries or resections.