Betz A, Stock W, Hierner R, Sebisch E, Schweiberer L
Klinikum Innenstadt, Ludwig-Maximilians-Universität München.
Handchir Mikrochir Plast Chir. 1995 May;27(3):141-8.
A 66-year-old patient attempted suicide by jumping in front of a train. The lower extremities were amputated at different levels. On the right side, there was a complete amputation within the distal third of the lower leg. Proximal to the amputation site, there was an extensive soft-tissue and bone defect. On the left side, there was a crush injury of the tarsal and mid-tarsal bones. The left lower leg showed only few injuries. An ipsilateral (anatomical) replantation was not possible. In order to save one lower extremity, we decided to carry out a cross-over (contralateral) replantation of the right foot to the left lower leg. After a follow-up of six years, the patient is able to walk well with her prosthesis on the right side and the right foot hooked up to the left lower leg. Functionally, this treatment (cross-over replantation-one-side prosthesis of the lower leg) is much better than the prosthesis on both extremities, as the result has shown. Also from a psychological point of view, it seems to be better for the patient to preserve one extremity even with a cross-over replanted foot.
一名66岁的患者试图卧轨自杀。其双下肢在不同平面被截肢。右侧小腿远端三分之一处完全离断。在离断部位近端，存在广泛的软组织和骨缺损。左侧跗骨和中跗骨有挤压伤。左小腿仅有少量损伤。同侧（解剖学意义上）再植无法实现。为了保住一条下肢，我们决定将右脚交叉（对侧）再植到左小腿。经过六年的随访，患者借助右侧的假肢以及连接到左小腿的右脚能够很好地行走。结果表明，从功能上看，这种治疗方式（交叉再植 - 一侧小腿假肢）比双侧安装假肢要好得多。而且从心理角度来看，即便有一只交叉再植的脚，保住一条下肢似乎对患者更好。
