RECONSTRUCTIVE AMPUTATION AFTER GRADE-IIIC OPEN TIBIAL FRACTURE - ONEMETHOD OF PRESERVING RESIDUAL LIMB LENGTH

A high percentage of patients with grade IIIC open tibial fractures ev entually undergo amputation. Maintaining an adequate residual limb len gth is advantageous with regard to biomechanics, energy expenditure, a nd prosthetic fitting. This case report presents new considerations fo r maintaining residual limb length in the presence of comminuted proxi mal tibial fractures. These considerations include (a) using an autoge nous fibular strut graft for stabilizing the reconstructed residual li mb and (b) determining the level of amputation based on soft-tissue in tegrity rather than on fracture level. We present one technique for pr eserving an adequate residual limb length in the face of significant p roximal tibia comminution.