title: A new incision technique to reduce tibiofemoral mismatch in rotationplasty.
abstract: Rotationplasty provides stable and durable biologic reconstruction after tumor resection around the knee and renders reliable results, in young patients. However, after resection of the tumor, there is often a mismatch between the circumference of the proximal (femoral) and the distal (tibial) parts. Because rotationplasty includes an intercalary amputation where the ends are readapted, there is always a mismatch of the proximal and distal circumferences of the soft tissue envelope. To facilitate skin closure without tension and to avoid impaired wound healing and subsequent infections, the type of incision is critical and must be carefully planned. We present a new incision technique for rotationplasty about the knee. Half of the difference of the incision length of the proximal and distal circumferences represents the base of the triangle proximally, medially and laterally of the thigh. After adapting both ends, the peak of this flat triangle is distally adapted via a vertical incision which allows it to match unequal circumferences. This technique was used in eight patients, in all of whom the wounds healed uneventfully.
authors.affiliation: Department of Orthopaedics, Division of Orthopaedic Oncology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Ossendorf
authors.forename: Gerhard U
authors.initials: GU
authors.lastname: Exner
authors.forename: Bruno
authors.initials: B
authors.lastname: Fuchs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D007870:Leg Length Inequality / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012399:Rotation; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult