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Amputation alternatives preserving bipedal ambulation

1997; Elsevier BV; Volume: 4; Issue: 4 Linguagem: Inglês

10.1016/s1071-0949(97)80026-1

1558-0741

Hans‐Ulrich Steinau, D. Hebebrand, Peter M. Vogt,

Orthopedic Infections and Treatments

The introduction of reconstructive plastic procedures in cases of post-traumatic or resectional defects, neuropathic ulcerations, and infections has considerably decreased the indication for amputation. Conventional parameters for below knee (BK)-ablation like tibial nerve severance, postischemia syndrome, avulsion injuries, chronic osteitis, foot deformities, and sole of the foot defects should be critically revised before mutilating surgery is advised. Interdisciplinary approach for limb salvage is mandatory in cases of high amputation levels, mutilating trauma during childhood, juvenile diabetes, or if iatrogenic factors play a crucial role. In case of partial foot amputation or oncologically required transverse or sagittal resections, conventional foot stumps, including free tissue transfer and restoration of muscular balance, should be considered to achieve rehabilitation results superior to BK-amputation.