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The Journal of Bone and Joint Surgery 79:1073-5 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Case Report

Use of an Osteocutaneous Plantar Free Flap for Salvage of a Below-the-Knee Amputation in a Child. A Case Report*

P. M. WATERS, M.D.{dagger} and B. A. TAYLOR, M.D.{dagger}, BOSTON, MASSACHUSETTS

Investigation performed at Children's Hospital, Boston


   Introduction
 
We report the results of a transplantation of a free flap that included the vascularized calcaneus and associated soft tissues in an attempt to obtain greater function after a below-the-knee amputation by providing sensate skin for prosthetic weight-bearing.


   Case Report
 
An eleven-year-old boy slipped and fell while trying to board a slow-moving train. The left leg was caught in the train tracks, and the train continued to move over it. He was taken to a nearby hospital for initial evaluation and then was transferred to our institution. The initial duration of ischemia was six hours. He had a devascularizing and degloving injury of the leg, which was rotated 360 degrees, was cold, was without a pulse, and was without motor function distal to the knee. There was only a six-millimeter-wide flap of dorsal skin attaching the knee to the foot. There was a segmental defect of muscle, bone, and neurovascular tissue that . . . [Full Text of this Article]


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