Lengthening the Transfemoral Amputation Stump Using Vascularized Flap From Amputated Limb: A Case Report

Area of Science:

• Orthopedic Surgery
• Pediatric Oncology
• Reconstructive Microsurgery

Background:

• Osteosarcoma recurrence can necessitate complex limb salvage or amputation.
• Transfemoral amputation poses challenges for prosthetic fitting and functional ambulation.
• Maximizing stump length is crucial for optimal prosthetic rehabilitation.

Purpose of the Study:

• To present a novel reconstructive technique for transfemoral amputation stump lengthening.
• To describe the use of a tibial osseocutaneous vascularized flap in this context.
• To evaluate the functional outcome in a pediatric patient with recurrent osteosarcoma.

Main Methods:

• A 10-year-old male with recurrent osteosarcoma underwent transfemoral amputation.
• A tibial osseocutaneous vascularized flap from the amputated limb was used to lengthen the stump.
• Plate-and-screw fixation was employed for the reconstruction.

Main Results:

• The osseocutaneous flap successfully lengthened the amputation stump.
• The patient achieved independent ambulation with a custom-made prosthesis at final follow-up.
• The technique facilitated a positive functional outcome despite extensive disease.

Conclusions:

• Osseocutaneous flap reconstruction is a viable novel technique for transfemoral amputation stump lengthening.
• This approach can improve functional outcomes in pediatric patients with recurrent osteosarcoma.
• Vascularized tissue transfer offers a solution for challenging amputation reconstructions.