Avoiding Above-the-Knee Amputation with a Free Tibiofibular–Talocalcaneal Fillet Flap and Free Latissimus Dorsi Flap

Abstract

Despite the advances achieved in reconstructive surgery, amputation is still the only option after some severe traumas. Preservation of the knee joint is considered a significant functional advantage. We present the case of a 39-year-old man with a comminuted Gustilo type IIIC open tibia fracture with massive bone loss. To achieve a well-fashioned amputation stump and preserve the knee joint, a free osteocutaneous fillet flap was performed, including the distal tibia and fibula, talus, and calcaneus bones. As a result, a sensate and long amputation stump covered with thick skin from the sole of the foot provided a stable coverage with an excellent functional result and adjustment to prosthesis.

Keywords

• fillet flap
• spare parts surgery
• free osteocutaneous fillet flap
• amputation
• bone defect