Abstract
Aims: In some severe lower limb injuries, the level of bone trauma enables preservation of knee joint only if the soft tissues can be reconstructed over the exposed bone. The options for soft-tissue reconstruction of an amputation stump are to use a ßap from the amputated distal part, a local ßap possibly after tissue expansion or a free ßap. Methods: To preserve an adequate length of stump we reconstructed 10 stumps with latissimus dorsi free ßaps: above the knee in one and below the knee in nine. The reconstructions were done during the acute post-traumaic phase in þve and for late problems with the stump in four patients. In one patient the reconstruction was done nine weeks after a below-knee amputation for ischaemic necrosis after septicaemia. Results: All ßaps survived, but the venous anastomosis had to be revised in three patients in the early post-operative period. All patients regained adequate ambulation for their daily activities. The ßap was secondarily debulked in three patients. Conclusions: Every effort should be made to preserve an adequate stump length, particularly in young patients with crushing injuries of the extremities and when there is severe or recurrent late stump ulceration. A latissimus dorsi musculocunaeous soft-tissue reconstruction is reliable and durable option for stump defects.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
