Sensate composite calcaneal flap in leg amputation: a full terminal weight-bearing surface-experience in eight adult patients

Author(s)

Livani, Bruno ; Castro, Gabriel ; Tonelli Filho, Jose Roberto ; Morgatho, Tamara Ramos ; Dias Mongon, Mauricio Leal ; Belangero, William Dias ; Davitt, Michael ; Carvalho, Jose Andre

• Document type: Journal article
• Source: STRATEGIES IN TRAUMA AND LIMB RECONSTRUCTION; v. 6, n. 2, p. 6-pg., 2011-08-01.

Abstract

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. (AU)

• FAPESP's process: 09/02089-3 - Immediate internal fixation with reamed interlocking nail and early soft tissue reconstruction of tibial open fractures
• Grantee: Bruno Livani
• Support Opportunities: Regular Research Grants