title: [Heterotopic replantation after bilateral lower leg amputation].
abstract: BACKGROUND
  Replantation is an established procedure in reconstructive surgery. In a bilateral lower leg amputation attempts should be made to rescue at least one extremity, if the patients' vital conditions are stable.
  
  
  METHODS
  We report on a patient who has suffered a bilateral lower leg amputation. Due to the complex injuries the left leg was heterotopically (cross-over) replanted to the right leg. At the left leg an above knee stump was created. In a second operation a soft tissue defect at the replanted extremity was covered by a free microvascular latissimus dorsi muscle flap. In addition, the tibial nerve was reconstructed. Thirteen months later the patient is able to walk with a prosthesis for his left leg and complete weight bearing of the replanted extremity.
  
  
  CONCLUSIONS
  Indication for replantation depends on accompanying injuries and vital functions of the patient. Compared to a simple amputation a lower leg replantation prolongs hospital stay, delays mobilisation of the patient, and increases the necessary secondary procedures. However, after replantation functional outcome is mostly better than with prosthetic fitting, especially if reconstruction of sensation in the weight-bearing area is successful. Thus, in a bilateral amputation movement and stability, as well as quality of life, are improved by a replanted extremity.
authors.affiliation: Klinik für Plastische, Wiederherstellungs-, und Handchirurgie, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg. hisham.fansa@medizin.uni-magdeburg.de
authors.forename: H
authors.initials: H
authors.lastname: Fansa
authors.forename: O
authors.initials: O
authors.lastname: Frerichs
authors.forename: W
authors.initials: W
authors.lastname: Schneider
mesh_terms: D000672:Amputation Stumps; D000673:Amputation, Traumatic / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000637:transplantation*; D007869:Leg Injuries / Q000601:surgery*; D008866:Microsurgery; D012092:Replantation / Q000379:methods*; D013524:Surgical Flaps; D013979:Tibial Nerve / Q000293:injuries / Q000601:surgery; D016042:Transplantation, Heterotopic / Q000379:methods*
vernacular_title: Heterotope Replantation nach bilateraler Unterschenkelamputation.