Kadam Dinesh
Department of Plastic & Reconstructive Surgery, A J Institute of Medical Sciences and A J Hospital & Research Centre, Kuntikana, Mangalore, India.
Indian J Plast Surg. 2010 Jan;43(1):108-10. doi: 10.4103/0970-0358.63964.
Below knee stump preservation reduces ambulatory energy expenditure and improves the quality of life. Reconstruction of soft tissue loss around the stump is a challenging task. Below knee stump reconstruction demands stable skin with sufficient soft tissue to allow weigh bearing. Microsurgical tissue transfer is increasingly being used as a salvage option. Anterolateral thigh flap with additional vastus lateralis muscle provides extra cushioning effect. We report two cases of amputation below knee successfully salvaged. The anterolteral flap with abundant tissue and stable skin offers a reliable option for cover. Two patients with below knee amputation were reconstructed secondarily. After 6 to 20 months of follow -up, stumps showed no signs of pressure effects. Patients are able to bear 50-70 hours of weight per week.
膝下残端保留可减少步行能量消耗并改善生活质量。残端周围软组织缺损的重建是一项具有挑战性的任务。膝下残端重建需要稳定的皮肤和足够的软组织以允许负重。显微外科组织移植越来越多地被用作挽救手段。带额外股外侧肌的股前外侧皮瓣可提供额外的缓冲作用。我们报告了两例成功挽救的膝下截肢病例。带有丰富组织和稳定皮肤的股前外侧皮瓣为覆盖提供了可靠选择。两名膝下截肢患者接受了二期重建。经过6至20个月的随访，残端未出现压力影响的迹象。患者每周能够承受50至70小时的负重。
