Revascularization of subtotal amputation at the ankle in children following motorcycle-spoke injury.

A prospective study of subtotal amputation of the ankle following motorcycle spoke injury was carried out to define the mechanism of the injury and results of revasculization. Between 1990 to 1995, there were 42 patients with this type of injury. They were 31 boys and 11 girls. All sustained severe skin lacerations, medial, posterior, lateral and anterior to the ankle joint. All tendons and neurovascular bundles medial, lateral and anterior to the ankle were completely torn, leaving tendons of anterior tibial, extensor hallucis longus and extensor digitorum communis intact. Revascularization was performed successfully in 38 patients. All had good functional outcome although varus of the distal tibia, limitation of ankle motion, shortening of the foot and limb length discrepancy were observed. The motorcycle wheel needs to be redesigned.