Salvage replantation of lower limb amputations

Three cases are reported in which the microsurgical salvage of parts of traumatic lower extremity amputations associated with degloved proximal skin loss provided sturdy, sensate skin and soft-tissue coverage and thereby preserved functional below-knee amputation levels. In two instances, a free innervated filletted flap was constructed from the foot of the amputated limb, and in the third case, the amputated lower leg was shortened, successfully replanted, and followed later by elective amputation of a foot at the Syme level. At a mean follow-up of 2 years, all three patients are ambulating well in below-knee prostheses.