Sensate composite calcaneal flap in leg amputation: a full terminal weight-bearing surface—experience in eight adult patients
Bruno Livani, Gabriel Castro, Jose Roberto Tonelli Filho, Tâmara Ramos Morgatho, Mauricio Leal Dias Mongon, William Dias Belangero, Michael Davitt, Jose André Carvalho
Keywords :
Heel, Leg, Extremities
Citation Information :
Livani B, Castro G, Filho JR, Morgatho TR, Mongon ML, Belangero WD, Davitt M, Carvalho JA. Sensate composite calcaneal flap in leg amputation: a full terminal weight-bearing surface—experience in eight adult patients. 2011; 6 (2):91-96.
Despite modern reconstruction techniques and replantation, the preservation of a severely traumatised limb, or even a limb affected by a congenital malformation, usually gives poorer functional results compared with amputation and prosthetisation. The aim of this study was to describe a hind foot (including the calcaneum and fat pad) sensate flap with a surface that allows full terminal weight bearing in transtibial amputations in adults. Between June 2007 and September 2008, eight patients underwent leg amputations with a sensate composite calcaneal flap reconstruction of the stump. Patients consisted of four men and four women with a mean age of 46.5 (26–66) years. All amputations were unilateral. The mean follow-up was 28.3 (25–42) months. There were no complications. Calcaneum tibial fusion was observed in all patients in a mean time of 3.5 (3–4) months. A below-knee prosthesis was adapted at 16 weeks postoperatively in all cases, and no need for stump revision occurred in this series during the entire follow-up period. A transtibial amputation covered with a sensate plantar flap preserving the calcaneum was proposed. In theory, the anatomic structures spared in this technique provide a strong, full, weight-bearing terminal surface of the stump that will last a lifetime.
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