Abstract
An anterior skin flap taken from the instep can be used to cover the bone ends in disarticulation of the ankle when ulceration or necrosis of the heel prevents the use of the heel flap for a conventional Syme’s amputation. From 1995 to 2003 December, we performed ankle disarticulation by using anterior flap after primary radical debridement in 42 cases with traumatic foot amputation injured by antipersonnel land mines. In all our cases, we observed wound healing in 2 weeks without any problems. The patients were advised to use a cylindrical bootee for indoor walking in third week. After 1–1.5 month, we put plastazote pad on stump end for prosthesis fitting, and for ourdoor walking the patients used prosthesis which would combine partial end-bearing and partial weight bearing on the patellar tendon. Ground contacting and standing without a prosthesis were also acceptable. We observed the advantages of prosthesis fitting. For instance, there is no need to open a window on the prosthesis socket for fitting and it is easier to fit the slender stump into the prosthesis. In early fitting we did not come across any problems about the slipping of the flap from stump as seen in conventional Syme’s amputation. In short and long term follow-ups, we found that the patients did not complain much about their prosthesis. For all these reasons, we think that ankle disarticulation with anterior flap rather than transtibial amputation should be preferred in patients with traumatic foot amputation since conventional Syme’s amputation can not be performed in heel injuries.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
