Pedicled Sensate Composite Calcaneal Flap to Achieve Full Weight-Bearing Surface in Midshaft Leg Amputations: Case Report

Livani, Bruno; Castro, Gabriel F de; Filho, José Roberto Tonelli; Belangero, William Dias; Ramos, Tamara Margatho; Mongon, Mauricio Leal Dias

doi:10.1055/s-0030-1267831

Cited by 4 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The post-surgery examination included a clinical examination and radiography. The 6-MWT 5 , 7 , 14 was performed during week 32 after the amputation ( Table 2 ).…”

Section: Methodsmentioning

confidence: 99%

“…The post-surgery assessment included clinical examination and radiography. The 6-MWT 5 , 7 , 14 was performed at week 32 after the amputation and at 1 year. The variables recorded at assessment included state of fusion, results of the 6-MWT, and patient satisfaction with the procedure.…”

Section: Methodsmentioning

confidence: 99%

“…It provides an excellent weight-bearing stump with no need for an artificial limb but its use has been restricted because of the difficulty of securing a successful tibiocalcaneal fusion (high nonunion rates). 5 The aim of the present study was to describe the use of the tension band technique 6 to achieve fusion in the Boyd amputation in six adults and to compare the 6 minute walk test (6 MWT) with the literature.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Boyd Amputation Using the Tension Band Technique

Mongon

Sposito

Nunes

et al. 2011

Strategies in Trauma and Limb Reconstruction

Self Cite

View full text Add to dashboard Cite

Background Amputation at the level of the hindfoot results in an equinus deformity from an imbalance of muscle-tendons acting across the ankle. Boyd’s reconstruction for hindfoot amputations is a well-known technique that retains the calcaneus and fuses it with the distal tibia at the ankle mortise. It provides an excellent weight-bearing stump and in most cases does not require an artificial limb but its use has been restricted because of the difficulty in obtaining high union rates in the tibiocalcaneal fusion. Materials and methods Five patients (four unilateral and one bilateral) underwent leg amputations from January 2012 to November 2013 using the Boyd technique for reconstructing the stump and were stabilized with a tension band. The study sample consisted of adult patients who had traumatic reasons for the amputation. Patients under 18 years old with a hindfoot that was inadequate for Boyd reconstruction (i.e., insufficient soft tissue coverage or no posterior tibial artery pulse) were excluded. One (case #2) had systemic comorbidities (e.g., hypertension, diabetes, chronic vascular insufficiency) as well as being a smoker. Three men and two women (mean age 39 years; range 21–61 years) were included. Three patients underwent amputation on the right side, one on the left side, and one bilaterally (case #5). All patients presented with Gustillo and Anderson IIIC open fractures. The mean time from lesion to amputation was 2.25 weeks (range 1–4 weeks). The mean follow-up duration was 16 (range 12–24) months. The post-surgery examination included a clinical examination and radiography. A 6 minute walk test (6 MWT) was performed on week 32 after the amputation. This study was carried out with the approval of our institution’s ethics committee. All patients provided a written informed consent form in accordance with the World Medical Association and the Declaration of Helsinki. Results All six stumps fused successfully. The 6 MWT results were comparable to those found in the literature for other lower limb amputees. Conclusion The tension band technique used as part of the Boyd amputation to achieve tibiocalcaneal fusion was effective in all five trauma patients. Sound fusion was achieved in all cases with the 6 MWT scores comparable to that in the literature. This technique should be considered an osteosynthesis option for the Boyd procedure. Level of evidence Level IV, retrospective study. How to cite this article Mongon MLD, Sposito AL, Nunes GMN, et al. Boyd Amputation Using the Tension Band Technique. Strategies Trauma Limb Reconstr 2019;14(2):102–105.

show abstract

“…The post-surgery examination included a clinical examination and radiography. The 6-MWT 5 , 7 , 14 was performed during week 32 after the amputation ( Table 2 ).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Boyd Amputation Using the Tension Band Technique

Mongon

Sposito

Nunes

et al. 2011

Strategies in Trauma and Limb Reconstruction

Self Cite

View full text Add to dashboard Cite

show abstract

Cortical tibial osteoperiosteal flap technique to achieve bony bridge in transtibial amputation: experience in nine adult patients

Mongon¹,

Piva²,

Neto³

et al. 2013

Strategies in Trauma and Limb Reconstruction

Self Cite

View full text Add to dashboard Cite

Amputation, especially of the lower limbs, is a surgical procedure that gives excellent results when conducted under the appropriate conditions. In 1949 Ertl developed a technique for transtibial osteomyoplastic amputation which restored the intraosseous pressure through canal obliteration and expanded the area of terminal support through a bony bridge between the fibula and distal tibia. The aim of this study was to investigate the effectiveness of a modification of the original Ertl’s technique in which a cortical osteoperiosteal flap created from the tibia is used to form a bony bridge during transtibial amputation in adults. Nine patients underwent leg amputations with the cortical tibial osteoperiosteal flap technique for reconstruction of the stump. The average duration of follow-up was 30.8 (range, 18–41) months. The post-surgery examination included a clinical examination and radiography. A 6-min walk test (Enright in Respir Care 48(8):783–785, 2003) was performed in the 32nd week after amputation. At 24th week post-surgery, all patients had stumps that were painless and able to bear full weight through the end. The creation of a cortical osteoperiosteal flap from the tibia to the fibula during transtibial amputation is a safe and effective technique that provides a strong and painless terminal weight-bearing stump. This constitutes a useful option for young patients, athletes, and patients with high physical demands.

show abstract