PMC2938606_01
The right below-knee stump in a 32 year old amputee who presented with unstable scar, recurrent chronic inflammation and failure to use prosthesis
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F0001
The stump had healed with secondary intention owing to insufficient soft tissue cover and infection [Figure 1].
Excised unstable scar and exposed prominent tibial projection along with harvested anterolateral thigh flap with vastus lateralis muscle. Vastus muscle is used to cover projecting bony stump
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F0002
About 2 cm tibial end was projecting in the wound [Figure 2].
End to end anastomosis to popliteal vessels, and muscle covering the bony stump
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F0003
Anastomosis was done end-to-end to popliteal vessels with minimal vessel diameter discrepancy [Figure 3].
Well settled flap at 20 months post surgery without any pressure ulcerations or flap redundancy
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F0004
He is symptom free at 20 months after the surgery and flap does not show any atrophy or redundancy [Figure 4].
Patient is ambulatory and he is on the prosthesis for about 70 hours per week
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F0005
His pain free walking distance has increased from half a mile preoperatively to two miles post-operatively [Figure 5].