Reconstructive amputation after grade IIIC open tibial fracture. One method of preserving residual limb length.
A high percentage of patients with grade IIIC open tibial fractures eventually undergo amputation. Maintaining an adequate residual limb length is advantageous with regard to biomechanics, energy expenditure, and prosthetic fitting. This case report presents new considerations for maintaining residual limb length in the presence of comminuted proximal tibial fractures. These considerations include (a) using an autogenous fibular strut graft for stabilizing the reconstructed residual limb and (b) determining the level of amputation based on soft-tissue integrity rather than on fracture level. We present one technique for preserving an adequate residual limb length in the face of significant proximal tibia comminution.
Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756-0001.
J M
JM
Hartford
W A
WA
Abdu
M B
MB
Mayor
D000063:Accidents, Traffic; D000328:Adult; D000671:Amputation, Surgical / Q000379:methods*; D001696:Biomechanical Phenomena; D005500:Follow-Up Studies; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005597:Fractures, Open / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007870:Leg Length Inequality / Q000517:prevention & control; D008297:Male; D011379:Prognosis; D017755:Prosthesis Fitting; D011859:Radiography; D016879:Salvage Therapy / Q000379:methods*; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*