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Modified Gritti-Stokes amputation: tips and tricks
Laura Walthert1, Michael Ris1, Kevin Moerenhout1
1Department of Orthopaedic and Traumatology, CHUV, Lausanne, Switzerland.
EFORT Open Reviews
|April 5, 2024
Summary
The Gritti-Stokes amputation (GSA) offers an excellent solution for major lower limb amputations when a below-knee amputation (BKA) is not feasible. This technique preserves knee function, aiding rehabilitation and optimal wound healing.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Amputation Techniques
Background:
- Major lower extremity amputations are necessitated by trauma, peripheral vascular disease, diabetes, and malignancies.
- Optimal functional outcomes and wound healing are primary goals in amputation surgery.
- Preserving the knee joint is crucial for successful patient rehabilitation.
Purpose of the Study:
- To describe the surgical technique and clinical experience with the Gritti-Stokes amputation (GSA).
- To highlight critical procedural steps for successful GSA.
- To evaluate GSA as an alternative when below-knee amputation (BKA) is not possible.
Main Methods:
- The Gritti-Stokes amputation involves a through-knee amputation with a pedicled patella flap.
- Surgical steps include distal femur osteotomy and patellar resurfacing.
- Anterior flap rotation covers the femur, creating a patellofemoral arthrodesis.
Main Results:
- The Gritti-Stokes amputation is presented as a viable option for major lower limb amputations.
- The technique aims to maximize limb length and facilitate wound healing.
- Successful patellofemoral arthrodesis is key to the procedure's effectiveness.
Conclusions:
- Gritti-Stokes amputation is an excellent surgical choice when BKA is contraindicated.
- Careful preoperative assessment and comorbidity management are essential.
- Meticulous surgical technique, including atraumatic handling and precise arthrodesis, is warranted.
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