1,041 results match your criteria Lower Extremity Reconstruction Tibia

Clinically Important Reductions in Physical Function and Quality of Life in Adults with Tumor Prostheses in the Hip and Knee: A Cross-sectional Study.

Clin Orthop Relat Res 2021 May 10. Epub 2021 May 10.

L. Fernandes, M. K. Zebis, Department of Midwifery, Physiotherapy, Occupational Therapy, and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark.

Background: Patients with a bone sarcoma who undergo limb-sparing surgery and reconstruction with a tumor prosthesis in the lower extremity have been shown to have reduced self-reported physical function and quality of life (QoL). To provide patients facing these operations with better expectations of future physical function and to better evaluate and improve upon postoperative interventions, data from objectively measured physical function have been suggested.

Questions/purposes: We sought to explore different aspects of physical function, using the International Classification of Functioning, Disability, and Health (ICF) as a framework, by asking: (1) What are the differences between patients 2 to 12 years after a bone resection and reconstruction surgery of the hip and knee following resection of a bone sarcoma or giant cell tumor of bone and age-matched controls without walking limitations in ICF body functions (ROM, muscle strength, pain), ICF activity and participation (walking, getting up from a chair, daily tasks), and QoL? (2) Within the patient group, do ICF body functions and ICF activity and participation outcome scores correlate with QoL?

Methods: Between 2006 and 2016, we treated 72 patients for bone sarcoma or giant cell tumor of bone resulting in bone resection and reconstruction with a tumor prosthesis of the hip or knee. Read More

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A Cadaveric Anatomical Study of the Relationship between Proximal Tibial Slope and Coronal Plane Deformity.

J Knee Surg 2021 Apr 28. Epub 2021 Apr 28.

Division of Pediatric Orthopaedic Surgery, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio.

Medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) are commonly used to characterize the geometry of proximal tibia and are important considerations in lower extremity realignment procedures and total knee arthroplasty. This study utilized a large cadaveric collection to explore relationships between tibial slope and coronal plane deformity of the tibia. We utilized 462 well-preserved skeletons (924 tibiae), excluding any with fracture or obvious rheumatologic or infectious findings. Read More

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Clinical outcomes and complications of surgical interventions for multiple myeloma lesions in the extremities and pelvis: A retrospective clinical study.

Acta Orthop Traumatol Turc 2021 Mar;55(2):159-165

Department of Orthopaedic Surgery and Traumatology, Marmara University, School of Medicine, İstanbul, Turkey.

Objective: This study aimed to assess the pain and functional status of patients who underwent various surgical interventions for the stabilization of selected multiple myeloma (MM) lesions in the extremities and pelvis and to investigate the rate of complications requiring reintervention.

Methods: Patients with MM who underwent various surgical interventions for the extremity or pelvic lesions were retrospectively reviewed. Change in the pain intensity was assessed using visual analogous scale (VAS) preoperatively, at the time of discharge, and at the final follow-up. Read More

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Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications.

Anat Cell Biol 2021 Apr 8. Epub 2021 Apr 8.

Department of Anatomy, Kasturba Medical College, Mangalore, India.

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. Read More

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Outcomes of severe lower limb injury with Mangled Extremity Severity Score ≥ 7.

Bone Joint J 2021 Apr;103-B(4):769-774

School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Aims: Complex fractures of the femur and tibia with associated severe soft tissue injury are often devastating for the individual. The aim of this study was to describe the two-year patient-reported outcomes of patients in a civilian population who sustained a complex fracture of the femur or tibia with a Mangled Extremity Severity Score (MESS) of ≥ 7, whereby the score ranges from 2 (lowest severity) to 11 (highest severity).

Methods: Patients aged ≥ 16 years with a fractured femur or tibia and a MESS of ≥ 7 were extracted from the Victorian Orthopaedic Trauma Outcomes Registry (January 2007 to December 2018). Read More

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Prophylactic Antibiotic Regimens In Tumor Surgery (PARITY): a multi-center randomized controlled study comparing alternative antibiotic regimens in patients undergoing tumor resections with endoprosthetic replacements-a statistical analysis plan.

Trials 2021 Mar 22;22(1):223. Epub 2021 Mar 22.

Department of Surgery, McMaster University, Hamilton, ON, L8V 1C3, Canada.

Background: Limb salvage with endoprosthetic reconstruction is the current standard practice for the surgical management of lower extremity bone tumors in skeletally mature patients and typically includes tumor resection followed by the functional limb reconstruction with modular metallic and polyethylene endoprosthetic implants. However, owing to the complexity and length of these procedures, as well as the immunocompromised nature of patients treated with chemotherapy, the risk of surgical site infection (SSI) is high. The primary research objective of the Prophylactic Antibiotic Regimens In Tumor Surgery (PARITY) trial is to assess whether a 5-day regimen of post-operative antibiotics decreases the risk of SSI at 1 year post-operatively compared to a 1-day regimen. Read More

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[Effectiveness of double-bundle anterior cruciate ligament reconstruction combined with anterolateral ligament reconstruction for revision].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Mar;35(3):330-336

Department of Orthopaedics, Orthopaedics Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

Objective: To investigate the effectiveness of double-bundle anterior cruciate ligament (ACL) reconstruction combined with anterolateral ligament (ALL) reconstruction in the treatment of revision patients with ACL graft failure.

Methods: Between January 2018 and June 2019, 15 patients underwent ACL revision with double-bundle ACL reconstruction combined with ALL reconstruction. There were 12 males and 3 females with an average age of 30. Read More

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Management of Gustilo Type IIIC Injuries in the Lower Extremity.

Clin Plast Surg 2021 Apr 29;48(2):267-276. Epub 2021 Jan 29.

Hansjorg Wyss Department of Plastic Surgery, NYU Langone Health, 303 East 33rd Street, New York, NY 10016, USA.

Gustilo IIIC injuries of the lower extremity pose a significant challenge to the reconstructive surgeon. Key principles include early vascular repair and serial debridement followed by definitive coverage within 10 days. Primary reconstructive options following vascular repair include the anterolateral thigh flap or the latissimus dorsi muscle flap. Read More

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Clinical and radiological assessment of the induced membrane technique using beta-tricalcium phosphate in reconstructive surgery for lower extremity long bone defects.

Bone Joint J 2021 Mar;103-B(3):456-461

Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.

Aims: To clarify the effectiveness of the induced membrane technique (IMT) using beta-tricalcium phosphate (β-TCP) for reconstruction of segmental bone defects by evaluating clinical and radiological outcomes, and the effect of defect size and operated site on surgical outcomes.

Methods: A review of the medical records was conducted of consecutive 35 lower limbs (30 males and five females; median age 46 years (interquartile range (IQR) 40 to 61)) treated with IMT using β-TCP between 2014 and 2018. Lower Extremity Functional Score (LEFS) was examined preoperatively and at final follow-up to clarify patient-centered outcomes. Read More

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The Impact of Inadequate Soft-tissue Coverage following Severe Open Tibia Fractures in Tanzania.

Plast Reconstr Surg Glob Open 2020 Dec 21;8(12):e3272. Epub 2020 Dec 21.

Division of Plastic and Reconstructive Surgery, Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, Calif.

Managing lower extremity fractures complicated by large soft-tissue defects is challenging for surgeons in low- and middle-income countries, and long-term quality of life (QOL) for these patients is unclear.

Methods: We examined QOL, surgical complications, and longitudinal outcomes in 10 patients with Gustilo-Anderson Classification Type IIIB open tibia fractures seen at an orthopedic institute in Tanzania, from December 2015 to March 2017. Patients completed follow-up at 2-, 6-, 12-, 26-, and 52-week time points, and returned for qualitative interviews at 2. Read More

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December 2020

[Study on vascular selection and reconstruction in tibial transverse transport].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Dec;34(12):1579-1584

Department of Ophthalmology, Kailuan General Hospital, Tangshan Hebei, 063000, P.R.China.

Objective: To explore the vascular conditions and the necessity of vascular reconstruction in the treatment of chronic ischemic diseases of lower extremities with tibial transverse transport (TTT) from the perspective of vascular surgery.

Methods: A clinical data of 59 patients with chronic ischemic disease of lower extremities treated by TTT between February 2014 and July 2019 were analyzed retrospectively. Among them, there were 41 patients with diabetic foot (DF), including Wagner grade 3-4, Texas grade 2-3, and stage B-D lesions; the disease duration ranged from 0. Read More

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December 2020

Recycling of flap pedicle in complex lower extremity reconstruction: A proof of free muscle flap neovascularization.

Arch Plast Surg 2020 Nov 15;47(6):619-621. Epub 2020 Nov 15.

Department of Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK.

This article portrays the authors' clinical experience of a complex case of lower extremity reconstruction using a recycled pedicle from 10 years old free latissimus dorsi musculocutaneous flap to supply a new free anterolateral thigh flap for proximal tibia wound defect reconstruction. It provides clinical evidence that muscle neovascularization occurs and supports the dogma peripheral tissue neovascularization. This case stipulates that recycling of pedicle is feasible, when used with appropriate strategy and safety and also provides evidence for the long-term survival of greater saphenous vein grafts in lower extremity reconstruction. Read More

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November 2020

The Free Fibula Flap for Lower Extremity Reconstruction.

Clin Podiatr Med Surg 2021 Jan 27;38(1):117-130. Epub 2020 Oct 27.

Foot & Ankle Surgery, Plastic Reconstructive & Microsurgery, Orthopaedic Trauma and MSK Infection Services, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA. Electronic address:

Reconstruction of critical size bone defects in the lower extremity poses a significant risk to not only limb malfunction but also amputation. The reconstructive goal of free bone flaps is to provide vascularized bone that restores length and stability. This applies to the native limb and also in amputations when a vascularized length of bone is required to maintain level of amputation. Read More

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January 2021

Partial Calcaneus Reconstruction using 'Opportunistic Grafts': A Case Report.

J Foot Ankle Surg 2021 Jan-Feb;60(1):199-203. Epub 2020 Sep 3.

Section of Orthopedic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.

Although replantation of an amputated extremity has been successfully performed, occasionally the surgeon is forced to amputate in the case of an unsalvageable open fracture. These appendages can theoretically act as an autologous 'bone and tissue bank' for patients if they have reconstructable contralateral injuries. We present a case of an athlete who sustained a Gustilo and Anderson IIIC injury on 1 leg resulting in a below knee amputation. Read More

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September 2020

Evolving evidence in the treatment of primary and recurrent posterior cruciate ligament injuries, part 1: anatomy, biomechanics and diagnostics.

Knee Surg Sports Traumatol Arthrosc 2021 Mar 17;29(3):672-681. Epub 2020 Nov 17.

Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, 3200 S. Water St, Pittsburgh, PA, 15203, USA.

The posterior cruciate ligament (PCL) represents an intra-articular structure composed of two distinct bundles. Considering the anterior and posterior meniscofemoral ligaments, a total of four ligamentous fibre bundles of the posterior knee complex act synergistically to restrain posterior and rotatory tibial loads. Injury mechanisms associated with high-energy trauma and accompanying injury patterns may complicate the diagnostic evaluation and accuracy. Read More

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Quadriceps Strength Is Influenced by Skeletal Maturity in Adolescents Recovering From Anterior Cruciate Ligament Reconstruction.

J Pediatr Orthop 2021 Feb;41(2):e141-e146

Departments of Orthopaedic Surgery.

Background: Anterior cruciate ligament injuries and anterior cruciate ligament reconstructions (ACLRs) are common, especially in adolescent patients. Recovery of strength, jumping performance, and perceived/subjective function are often used to make a return to sports decisions after injury. It is unknown how skeletal maturity may influence strength recovery after ACLR. Read More

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February 2021

When is the Critical Time for Soft Tissue Reconstruction of Open Tibia Fracture Patients?

J Reconstr Microsurg 2021 Mar 14;37(3):249-255. Epub 2020 Oct 14.

Department of Plastic and Reconstructive Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.

Background:  The timing of soft tissue reconstruction for soft-tissue defect in patients with open fractures in the lower extremity is known to be critical for successful outcomes. However, medical advances, including development of dressing materials and refinement in the microsurgical techniques, might have undergone modifications in this "critical period." There have been no studies on the role of timing on reconstructive outcomes. Read More

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Reliability of Low-dose Biplanar Radiography in Assessing Pediatric Torsional Pathology.

J Pediatr Orthop 2021 Jan;41(1):33-39

Rady Children's Hospital, San Diego, San Diego, CA.

Background: Low-dose biplanar radiographs (LDBRs) significantly reduce ionizing radiation exposure and may be of use in evaluating lower extremity torsion in children. In this study, we evaluated how well femoral and tibial torsional profiles obtained by LDBR correspond with 3-dimensional (3D) computed tomography (CT) and magnetic resonance axial imaging (MRI) in pediatric patients with suspected rotational abnormalities.

Methods: Patients who had both LDBR and CT/MRI studies performed for suspected lower extremity rotational deformities were included. Read More

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January 2021

Development of a specimen-specific in vitro pre-clinical simulation model of the human cadaveric knee with appropriate soft tissue constraints.

PLoS One 2020 14;15(10):e0238785. Epub 2020 Oct 14.

Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom.

A human cadaveric specimen-specific knee model with appropriate soft tissue constraints was developed to appropriately simulate the biomechanical environment in the human knee, in order to pre-clinically evaluate the biomechanical and tribological performance of soft tissue interventions. Four human cadaveric knees were studied in a natural knee simulator under force control conditions in the anterior posterior (AP) and tibial rotation (TR) axes, using virtual springs to replicate the function of soft tissues. The most appropriate spring constraints for each knee were determined by comparing the kinematic outputs in terms of AP displacement and TR angle of the human knee with all the soft tissues intact, to the same knee with all the soft tissues resected and replaced with virtual spring constraints (spring rate and free length/degree). Read More

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November 2020

Lower Leg Reconstruction With Free Tissue Transfer Using Reverse Flow Recipient Vein: A Case Report.

Int J Low Extrem Wounds 2020 Sep 25:1534734620959184. Epub 2020 Sep 25.

Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea.

Since the introduction of distally based flap, the concept of reverse flow flap was expanded to free tissue transfers. For recipient vessels, retrograde arterial inflow is considered a safe option for anastomosis. However, the reliability of a retrograde recipient vein remains controversial. Read More

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September 2020

[External fixator: temporary fixation and soft tissue management of the ankle].

Oper Orthop Traumatol 2020 Oct 18;32(5):421-432. Epub 2020 Sep 18.

UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Deutschland.

Objective Of Surgery: Joint-spanning transfixation of the ankle joint aims at mostly temporary retention of the reduction, i.e. restoring length and axial alignment and stabilization of the ankle mortise in highly unstable fractures around the ankle and under critical soft tissue conditions. Read More

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October 2020

Lower Limb Muscle Flaps: The Reverse Peroneus Brevis Flap.

Clin Podiatr Med Surg 2020 Oct;37(4):649-670

Department of Podiatric Surgery, TriHealth - Bethesda North Hospital, Montgomery, OH, USA; Cincinnati Lower Extremity Reconstructive Institute, Foot and Ankle Specialists of Cincinnati. Electronic address:

Chronic ulcerations of the lower extremity centered around the lateral malleolus, medial malleolus, Achilles tendon, or anterior ankle are complex and difficult to heal with conventional treatment modalities. With the evolution of orthoplastics and microsurgery techniques, the peroneus brevis muscle flap has been shown to be simple, versatile, and effective in management of small to medium-sized soft tissue defects that may or may not have exposed bone, tendon, or both. This article reviews the peroneus brevis muscle flap in lower extremity reconstruction and presents pertinent real-world cases of its applications as a tool for limb salvage and orthoplastic reconstruction. Read More

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October 2020

Distally Based Medial Hemisoleus Muscle Flap for Wound Coverage in the Distal Third of the Leg.

Clin Podiatr Med Surg 2020 Oct 13;37(4):631-647. Epub 2020 Aug 13.

University of Cincinnati Medical Center, Cincinnati Veteran Affairs Medical Center, 231 Albert Sabin Way, ML 0513, Cincinnati, OH 45276, USA. Electronic address:

Wound healing and coverage of soft tissue defects of distal tibia are challenging. Free tissue transfer is treatment of choice for distal tibial defects. However, resources for free tissue transfer are not readily available and they increase morbidity to host. Read More

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October 2020

Proximal tibial morphology and risk of posterior tibial cortex impingement in patients with AA-sized Oxford unicompartmental knee arthroplasty tibial implants.

J Orthop Surg Res 2020 Sep 3;15(1):380. Epub 2020 Sep 3.

Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, No. 5, Fu-Hsin Street, Kweishan, Taoyuan, Taiwan.

Background: In cases of Oxford unicompartmental knee arthroplasty (UKA), an increase in anteroposterior and medial-lateral length is usually disproportional when comparing AA and A-sized tibial components. Asynchronous increments may cause tibial keel impingement leading to complications.

Methods: Radiographic measurements were performed in five patients with AA-sized tibial implants. Read More

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September 2020

Expanding the horizons of clinical applications of proximal humerus locking plates in the lower extremities: A technical note.

Chin J Traumatol 2020 Dec 12;23(6):331-335. Epub 2020 Aug 12.

Missouri Orthopaedic Institute, University of Missouri, Columbia, United States.

Pre-contoured anatomical locking plates were designed to address the clinical need of fixing small epiphyseal segments with a larger number of screws. Those plates match the contour and shape of a variety of bones allowing for optimal buttress properties. The aim of this manuscript is to highlight the benefits of applying proximal humerus locking plates in the fixation of lower extremity bones. Read More

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December 2020

[Research progress of tibial transverse transport in treatment of chronic ischemic diseases of the lower extremities].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Aug;34(8):994-999

The Second Clinical College of Zhejiang Traditional Chinese Medical University, Hangzhou Zhejiang, 310053, P.R.China.

Objective: To summarize the research progress of tibial transverse transport (TTT) in treatment of chronic ischemic diseases of the lower extremities.

Methods: The related literature was systematically searched and the mechanisms, clinical treatment methods, clinical efficacy, indications, contraindications, and complications of TTT were discussed.

Results: Based on the law of tension-stress, TTT is a new method in the treatment of chronic ischemic diseases of the lower extremities. Read More

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[Research progress of tibial transverse transport for diabetic foot].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Aug;34(8):969-973

Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Shaanxi, 710061, P.R.China.

Objective: To summarize the research progress of tibial transverse transport in the treatment of diabetic foot.

Methods: The domestic and foreign literature on the tibial transverse transport for diabetic foot in recent years was summarized, and the advantages and disadvantages of the technique were analyzed.

Results: The tibial transverse transport was an innovation based on Ilizarov technique. Read More

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[Expert consensus on the treatment of diabetic foot ulcers using tibial transverse transport (2020)].


Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Aug;34(8):945-950

Ilizarov first reported the tibial transverse transport (TTT) for limb regeneration and functional reconstruction. The law of tension-stress could activate and enhance the regenerative potentials of living tissues, leading to growth or regeneration of muscles, fascia, blood vessels, and nerves simultaneously. Ilizarov discovered the phenomenon of rich vascular network formation during distraction osteogenesis process, but he did not apply this technique purposely to reconstruct microcirculation. Read More

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Intercalary Allograft Reconstruction of the Proximal Tibia With and Without a Free Fibula Flap in Pediatric Patients.

J Pediatr Orthop 2020 Oct;40(9):e833-e838

Department of Orthopedic Surgery.

Background: Limb salvage of the proximal tibia can be difficult due to the growth potential of and functional demands of the pediatric patients. Multiple reconstruction techniques exist, however, the ideal form of reconstruction is yet to be elucidated. The purpose of the current study is to evaluate outcomes in patients with an intercalary resection of the proximal tibia reconstructed with an allograft with or without a free vascularized fibula flap (FVF). Read More

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October 2020

Preserving the Knee in the Setting of High Segmental Tibial Bone and Massive Soft-Tissue Loss Using Vascularized Distal Tibial Bone Docking and a Foot Fillet Flap: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e0496

1Wright State University, Boonshoft School of Medicine, Dayton, Ohio 2Department of Orthopedic and Plastic Surgery, Wright State University, Boonshoft School of Medicine, Dayton, Ohio.

Case: We discuss our reconstructive approach to avoid an above-knee amputation in a 33-year-old man presenting after lower extremity crush injury. We used a vascularized tibial bone flap and a foot fillet flap to restore length and joint functionality to the residual limb. The patient ambulates with good prosthetic fit on durable heel pad skin and 100° active knee motion. Read More

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February 2021