[Technical surgical possibilities for preserving an end-bearing knee exarticulation stump in skin necrosis]

Disarticulation of the knee results in an excellent end-bearing stump. Operative technique is easy, fast and gentle. The muscular balance in the femur is not disturbed. The shape of the stump provides excellent rotation control in the prosthesis. New socket designs and prosthetic knee mechanisms have eliminated the former cosmetic problems concerning this amputation level. Nevertheless--because of external rotation of the femur, poor skin quality or wound closure under tension skin necrosis can occur, most of the times concerning the lateral condyle region. Several operative possibilities to get a satisfactory wound closure while preserving the advantages of this stump are presented.