Amputation Stump Revision Using a Free Sural Neurocutaneous Perforator Flap.

Abstract

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. 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. 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. 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.