[Fillet flap transfer as alternative to conventional lower limb amputation]

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Prosthetics

Background:

• Lower limb amputation presents significant challenges in prosthesis fitting.
• Current methods like skeletal stump-prosthesis interfaces and nerve transfers have limitations and introduce new impairments.
• Innovative surgical approaches are necessary to address these issues.

Purpose of the Study:

• To review prosthesis-associated discomforts and current treatment strategies.
• To present alternative surgical concepts, focusing on fillet flap techniques.
• To evaluate the advantages and disadvantages of various surgical options.

Main Methods:

• A selective literature search was conducted.
• Authors' experiences and perspectives on surgical treatment options were considered.
• A clinical case study is presented to illustrate the technique.

Main Results:

• Transferring the sole of the foot as a fillet flap creates a fully weight-bearing stump.
• This method prevents neuralgia, preserves sensation, and maintains body image.
• The technique is applicable to below and above-knee amputations, provided the calcaneal region is intact.

Conclusions:

• Fillet flap transfer optimizes the residual limb for prosthesis fitting.
• Individual patient evaluation is crucial for determining bone inclusion in the flap.
• This approach enhances the potential for successful prosthesis use and patient satisfaction.