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Related Experiment Videos

Modified skew-flap below-knee amputation.

Amitabh Jitendra Dwyer1, Rajesh Paul, Maharaj Krishan Mam

  • 1Department of Orthopedic Surgery, Christian Medical College and Hospital, Ludhiana, Panjab, India. amitabhdwyer@yahoo.com

American Journal of Orthopedics (Belle Mead, N.J.)
|April 28, 2007
PubMed
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This study presents a modified skew-flap technique for below-knee amputation in diabetic patients. The modified technique improved wound healing and prosthesis use, with 28 of 35 patients ambulating successfully.

Area of Science:

  • Surgical techniques
  • Diabetic limb salvage
  • Amputation procedures

Background:

  • Diabetes mellitus is a leading cause of lower extremity amputations.
  • Traditional below-knee amputation techniques can lead to complications affecting prosthetic use.
  • Improved surgical methods are needed to enhance outcomes for diabetic patients requiring amputation.

Purpose of the Study:

  • To describe a modified skew-flap technique for below-knee amputation.
  • To evaluate the efficacy and outcomes of this modified technique in diabetic patients.
  • To highlight the advantages of the modified approach for wound healing and ambulation.

Main Methods:

  • Prospective study of 35 consecutive diabetic patients undergoing modified skew-flap below-knee amputation between 1999 and 2001.

Related Experiment Videos

  • Detailed description of the surgical technique, including muscle cushioning and flap design.
  • Follow-up assessment of patient outcomes, including ambulation with prosthesis and complications.

    • Main Results:

    • At a mean follow-up of 3.5 years, 28 out of 35 patients (80%) were ambulating with a below-knee prosthesis.
    • Only 3 patients required amputation of the opposite extremity.
    • Four patients expired during the follow-up period.

    Conclusions:

    • The modified skew-flap technique offers significant advantages for below-knee amputation in diabetic patients.
    • Key modifications include tibialis anterior muscle cushioning, tension-free skin flaps, and oblique myocutaneous flaps.
    • These modifications contribute to improved wound healing, reduced complications, and successful ambulation with a prosthesis.