title: Functional reconstruction of ischemic contracture in the lower limb.
abstract: OBJECTIVE
  To discuss the method of functional reconstruction of ischemic contracture in the lower limb and propose a classification protocol for ischemic contracture in the lower limb based on its severity and prognosis.
  
  
  METHODS
  A total of 42 patients with ischemic contracture in the lower limb were included in this study. According to different types of disturbance and degrees of severity, surgical reconstructions consisting of nerve decompression, tendon lengthening or transfer, intrinsic foot muscle release and sural-tibial nerve anastomosis were performed in every patient.
  
  
  RESULTS
  Postoperatively, all patients were able to walk on flat ground. Drop foot was corrected in 10 patients, and 5 patients still felt some difficulty during stair activity. Split Achilles tendon transfer to flexor hallucis longus tendon was performed in 12 patients, and their walking stability was improved. Seven patients accepted ipsilateral sural-tibial nerve anastomosis, and sensitivity recovery reached to S2 in 2 patients and S3 in 5 patients.
  
  
  CONCLUSIONS
  Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb.
authors: Department of Orthopedics, Changhai Hospital, Second Military University, Shanghai 200433, China.
authors: Hao
authors: H
authors: Tang
authors: Shao-Cheng
authors: SC
authors: Zhang
authors: Zhang-Yong
authors: ZY
authors: Tan
authors: Hong-Wei
authors: HW
authors: Zhu
authors: Qiu-Lin
authors: QL
authors: Zhang
authors: Ming
authors: M
authors: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D054061:Ischemic Contracture / Q000503:physiopathology / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D016138:Walking