[Replantation at lower leg level].
BACKGROUND
Replantation in reconstructive surgery is an established procedure due to microsurgical techniques. It can be routinely performed in unilateral lower leg amputation. In some cases of bilateral amputation, in which orthotopic replantation is not possible due to the complex trauma, heterotopic replantation is a therapeutic option. This avoids prosthetic fitting.


METHODS
We report five cases of orthotopic and two of heterotopic lower limb replantations. Functional outcome concerning sensibility, mobility, pain, and aesthetic result were assessed clinically and using a questionnaire.


RESULTS
Functional outcome and patient satisfaction were good. The psychological situation of the patients as well as mobility and stability of the replanted limbs were satisfying. Heterotopically replanted patients found the replanted legs superior to the prostheses.


CONCLUSIONS
We conclude that, in lower leg amputation, attempts should be made to replant the extremity. In bilateral lower leg amputations, at least one limb should be reconstructed, even if "only" a heterotopic replantation can be performed.
Daigeler
A
A
Klinik für Plastische, Wiederherstellungs- und Handchirurgie, Otto-von-Guericke-Universität Magdeburg.
Fansa
H
H
Westphal
T
T
Schneider
W
W
D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D001186:Artificial Limbs; D004954:Esthetics; D016267:External Fixators; D005260:Female; D006801:Humans; D007866:Leg / Q000502:physiology / Q000601:surgery*; D008297:Male; D009790:Occupations; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011890:Railroads; D012086:Reoperation; D012092:Replantation / Q000379:methods / Q000534:rehabilitation; D016038:Skin Transplantation; D017768:Skin, Artificial; D013406:Suicide, Attempted; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking