salvage of a below-the-knee amputation level following a type-iiib open tibial fracture by steven...

Salvage of a Below-the-Knee Amputation Level Following a Type-IIIB Open Tibial Fracture

by Steven J. Morgan, Justin Newman, Kagan Ozer, Wade Smith, and Raffi Gurunluoglu

J Bone Joint Surg AmVolume 89(12):2769-2778

December 1, 2007

©2007 by The Journal of Bone and Joint Surgery, Inc.

Clinical photograph depicting the status of the soft tissues and associated muscle loss following the initial débridement of the type-IIIB open tibial fracture.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior radiograph, made following débridement of avascular bone and application of a unilateral external fixator, showing approximately 17 cm of bone loss from the tibial tubercle to

the distal tibial diaphysis.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A through 3-D Line drawings illustrating surgical progression and technique.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-B The appearance of the leg just prior to the turn-back procedure.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-C As the flap is turned back, the decorticated distalmost aspect of the tibia (the plafond) rotates with the flap.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-D The distalmost aspect of the tibia has been impacted into the metaphyseal portion of the tibia.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

The condition and appearance of the soft tissues at the completion of the procedure.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Clinical photograph of the residual extremity following extensive rehabilitation, demonstrating full extension of the limb from a lateral perspective.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.

Clinical photograph demonstrating the functional result obtained with the patient wearing the prosthesis.

Steven J. Morgan et al. J Bone Joint Surg Am 2007;89:2769-2778

©2007 by The Journal of Bone and Joint Surgery, Inc.