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CC BY-NC-ND 4.0 · Indian J Plast Surg 2010; 43(01): 108-110
DOI: 10.1055/s-0039-1699417
Case Report
Association of Plastic Surgeons of India

Secondary reconstruction of below knee amputation stump with free anterolateral thigh flap

Dinesh Kadam
Department of Plastic & Reconstructive Surgery, A J Institute of Medical Sciences and A J Hospital & Research Centre, Kuntikana, Mangalore, India
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Publication History

Publication Date:
08 January 2020 (online)

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ABSTRACT

Below knee stump preservation reduces ambulatory energy expenditure and improves the quality of life. Reconstruction of soft tissue loss around the stump is a challenging task. Below knee stump reconstruction demands stable skin with sufficient soft tissue to allow weigh bearing. Microsurgical tissue transfer is increasingly being used as a salvage option. Anterolateral thigh flap with additional vastus lateralis muscle provides extra cushioning effect. We report two cases of amputation below knee successfully salvaged. The anterolteral flap with abundant tissue and stable skin offers a reliable option for cover. Two patients with below knee amputation were reconstructed secondarily. After 6 to 20 months of follow -up, stumps showed no signs of pressure effects. Patients are able to bear 50-70 hours of weight per week.

KEY WORDS

Amputation stump salvage - knee stump reconstruction - free flaps for stump - aterolateral thigh flap
 

  • REFERENCES

  • 1 Waters RL, Perry J, Antonelli D, Hislop H. Energy cost of walking of amputees: the influence of level of amputation. J Bone Joint Surg Am 1976;58:42.
  • 2 Yildirim S, Calikapan GT, Akoz T. Reliable option for reconstruction of amputation stumps: the free anterolateral thigh flap. Microsurgery 2006;26:386-90.
  • 3 Shenaq SM, Krouskop T, Stal S, Spira M. Salvage of amputation stumps by secondary reconstruction utilizing microsurgical freetissue transfer. Plast Reconstr Surg 1987;79:861-70.
  • 4 Erdmann D, Sundin BM, Yasui K, Wong MS, Levin LS. Microsurgical free flap transfer to amputation sites: indications and results. Ann Plast Surg 2002;48:167-72.
  • 5 Baccarani A, Follmar KE, De Santis G, Adani R, Pinelli M, Innocenti M, et al. Free vascularized tissue transfer to preserve upper extremity amputation levels. Plast Reconstr Surg 2007;120:971-81.
  • 6 Gallico GG 3rd, Ehrlichman RJ, Jupiter J, May JW Jr. Free flaps to preserve below-knee amputation stumps: long-term evaluation. Plast Reconstr Surg 1987;79:871-8.
  • 7 Kasabian AK, Colen SR, Shaw WW, Pachter HL. The role of microvascular free flaps in salvaging below-knee amputation stumps: a review of 22 cases. J Trauma 1991;31:495-500.
  • 8 Tukiainen EJ, Saray A, Kuokkanen HO, Asko-Seljavaara SL. Salvage of major amputation stumps of the lower extremity with latissimus dorsi free flaps. Scand J Plast Reconstr Surg Hand Surg 2002;36:85-90.
  • 9 Hallock GG. Preservation of lower extremity amputation length using muscle perforator free flaps. J Plast Reconstr Aesthet Surg 2008;61:643-47.