Journal Basic Info
- Impact Factor: 1.995**
- H-Index: 8
- ISSN: 2474-1647
- DOI: 10.25107/2474-1647
Major Scope
- Robotic Surgery
- Neurological Surgery
- General Surgery
- Vascular Surgery
- Colon and Rectal Surgery
- Cardiovascular Surgery
- Ophthalmic Surgery
- Emergency Surgery
Abstract
Citation: Clin Surg. 2017;2(1):1380.Case Report | Open Access
Lower Limb Salvage at any Cost - A Complex Case
Amir K Bigdeli, Frederick J Hernekamp, Florian Neubrech, Nico Leibig, Chrisitan Radu, Emre Gazyakan, Ulrich Kneser and Thomas Kremer
Department of Hand and Plastic Surgery, University of Heidelberg, Heidelberg, Germany
*Correspondance to: Amir Khosrow Bigdeli
PDF Full Text DOI: 10.25107/2474-1647.1380
Abstract
Lower limb salvage for osteomyelitis of the tibia after open fracture presents an ongoing challenge. In the field of modern reconstructive surgery, we increasingly find ourselves asking “What can we salvage?” instead of “What should we salvage?” We report the case of a 37-year-old male patient, who sustained an open tibial fracture in a motorcycle accident. He underwent more than thirty operative procedures for lower limb reconstruction over a five-year period. Complicated by osteomyelitis, limb salvage was finally achieved with a free contralateral vascularized osteocutaneus fibular transfer after 13-hour surgery. The combination with an arterio-venous loop was necessary for and created through the cephalic and small saphenous vein as unusual feature due to sacrifice of autologous vein grafts for previous reconstructive procedures. Two years later, the patient is satisfied with his limb function and has returned to work. The free osteocutaneous vascularized fibula transfer prevented lower limb amputation but still remains complex and invasive. We want to discuss aspects of decision-making involving clinicians as well as the patient and recommend the installation of multidisciplinary extremity boards.
Keywords
Free fibula; Distal tibia fracture; Limb salvage; Arteriovenous loop
Cite the article
Bigdeli AK, Hernekamp FJ, Neubrech F, Leibig N, Radu C, Gazyakan E, et al. Lower Limb Salvage at any Cost - A Complex Case. Clin Surg. 2017; 2: 1380.