Gritti-Stokes Amputation in the Trauma Patient: Tips and Techniques.

Abstract

The Gritti-Stokes amputation establishes osseous continuity between the patella and the distal part of the femur with maintenance of the intact prepatellar soft tissues. As with all orthopaedic surgery, preoperative planning is essential to obtaining an optimal outcome with this procedure. Use an asymmetric flap consisting of the undisturbed prepatellar soft tissues and rotate it posteriorly to achieve closure. Keep soft-tissue dissection subperiosteal or intratendinous to minimize blood loss and postoperative pain. Use a high-speed saw to transect the femur and patella. Carry out posterior dissection in a methodical manner, with individual identification and ligation of all neurovascular structures. Suture the patella to the distal part of the femur using six drill holes and nonabsorbable suture. Close the remaining soft tissue, including the posterior musculature, subcutaneous layer, and skin, in a layered fashion. Postoperative care should be done in conjunction with a prosthetist to obtain optimal outcomes. The Gritti-Stokes amputation technique appears to be a potentially valuable addition to the amputation surgeon's armamentarium. IndicationsContraindicationsPitfalls & Challenges.