SPARE PARTS SURGERY FOR SALVAGE OF TRAUMATIC BELOW-KNEE AMPUTATION STUMP : A CASE REPORT

Abstract

　　A 39-year-old male sustained open left knee joint fracture with 8cm bone defect and 12×15cm soft-tissue loss after ａ car accident. Thirteen days post-injury, reconstruction with ａ free flap was performed. Unfortunately, it failed due to venous embolism. Twenty-one days post-injury, below-knee amputation was performed using ａ long posterior tibial artery flap. The flap with the distal part of tibia was flipped upside-down and fixed to the proximal tibia, covering the soft tissue defect completely. Three months later, knee function and residual limb length was preserved, and the patient was ambulating well with ａ below-knee prosthesis. One of the major benefits of spare parts surgery is when there is not enough local tissue to perform below-knee-amputation, the flap can supply extra tissue and may prevent above-knee-amputation. We encourage the use of spare parts surgery in amputation following extensive extremity trauma.