Amputation stump salvage using a "banked" free-tissue transfer

Area of Science:

• Orthopedic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Limb salvage and reconstruction present complex challenges, often requiring multiple surgical interventions.
• Free flaps are a common reconstructive tool, but their application can be limited by donor site morbidity and the need for complex microvascular anastomoses.

Observation:

• A free radical forearm flap was salvaged from a nonreplantable amputated extremity.
• The flap was initially banked on the ipsilateral chest wall for viability.
• Subsequently, the flap was rotated to cover a proximal humeral stump defect.

Findings:

• The salvaged free flap provided successful coverage for the proximal humeral stump.
• The flap's rotation eliminated the necessity for a second microvascular procedure, simplifying the reconstructive process.

Implications:

• This technique offers a potentially streamlined approach to reconstructive surgery following limb amputation.
• It highlights the versatility of free flaps and innovative surgical planning in limb salvage.
• This method may reduce operative time and resource utilization in complex orthopedic reconstructions.