Clin Surg | Volume 6, Issue 1 | Research Article | Open Access

The Reconstructive Ladder for Revision Surgery of Combat Amputees

Ernst Jennifer1,2*, Luis Pardo Jr1, Judith C Witzel1, Erik Andres3, Johannes Siegel3, Daniela Wüstefeld3, Wolfgang Lehmann1, Frank Braatz1 and Gunther Felmerer1

1Department for Trauma Surgery, Orthopedic Surgery and Plastic Surgery, University Medical Center Göttingen, Germany 2Department for Trauma Surgery, Hannover Medical School, Hanover, Germany
3Ottobock, Patient Care Center Duderstadt, Germany

*Correspondance to: Jennifer Ernst 

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Findings and Outcomes: Combat injury related amputations are associated with a higher number of complications. Little attention has been given to the role of surgical treatment concepts to treat residual limb pain after combat-related amputations and complications at the residual limb. This case series shows the impact of surgery and of the reconstructive ladder in the management of complications after combat injury related amputations for 10 amputees. After conservative treatment methods have been exhausted, a treatment algorithm considering the reconstructive ladder seems to direct the appropriate surgical techniques to targets at the residual limb thereby reducing pain and managing complications at the residual limb. The result is better prosthetic fitting and successful rehabilitation for the amputee. Conclusion: Revision surgery including microsurgical techniques targeting identified pathology at the residual limb should be considered to reduce residual limb pain and to manage complications after combat-related amputations.


Revision surgery; Amputation; Residual limb pain; Phantom limb pain; Neuroma; Scars


Jennifer E, Pardo Jr L, Witzel JC, Andres E, Siegel J, Wüstefeld D, et al. The Reconstructive Ladder for Revision Surgery of Combat Amputees. Clin Surg. 2021; 6: 3363..

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