Amputation Stump Revision Using a Free Sural Neurocutaneous Perforator Flap.
BACKGROUND
The development of microsurgery and the concept of the surgical flap have enabled orthopedic surgeons to deal with various soft tissue defects and compositions during limb salvage procedures. However, severely damaged bony structures with accompanying soft tissue deficiencies often result in amputation. When performing amputations, surgeons must preserve the stump length to maximize functional ambulation, even during the posttraumatic phase and chronic period when a fillet flap is not an option.


METHODS
Eleven patients with previous below-knee amputation were enrolled in our study from January 2006 to December 2011. Each patient underwent stump revision using a free sural neurocutaneous perforator flap. Preoperative and postoperative data were reviewed to evaluate the functional and aesthetic results.


RESULTS
The 11 patients comprised 7 men and 4 women with an average age of 35.6 years (range, 26.0-49.0 years). The mean follow-up period was 15.3 months (range, 10.0 months-2.0 years). All free flap reconstructions of the amputation stump ultimately survived. All patients achieved both superficial and deep sensory recovery and are comfortable with their prostheses, and none have required further surgical intervention.


CONCLUSIONS
The sural neurocutaneous perforator flap provided stable coverage and improved patients' quality of life by aiding in early rehabilitation and prosthetic fitting, function, and comfort.
From the Department of Repair and Reconstruction Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Shengdi
S
Lu
Chunyang
C
Wang
Wanrun
W
Zhong
Pengfei
P
Chen
Yimin
Y
Chai
D000328:Adult; D000672:Amputation Stumps / Q000098:blood supply / Q000601:surgery*; D000673:Amputation, Traumatic / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007869:Leg Injuries / Q000601:surgery; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D056888:Patient Positioning; D061525:Perforator Flap / Q000098:blood supply / Q000294:innervation / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*