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Case Reports
. 2020 Mar;47(2):182-186.
doi: 10.5999/aps.2018.00514. Epub 2019 Aug 30.

Successful ankle replantation in two cases with different presentations

Adzim Poh Yuen Wen  1   2   3 , Mohd Hanifah Jusoh  1   4 , Arman Zaharil Mat Saad  1   2 , Ahmad Sukari Halim  1   2 , Nu'man Wan Ismail Wan Faisham  1   4 , Wan Sulaiman Wan Azman  1   2
Affiliations
Case Reports

Successful ankle replantation in two cases with different presentations

Adzim Poh Yuen Wen et al. Arch Plast Surg. 2020 Mar.

Abstract

We report our experience of treating two patients with ankle amputation with different presentations. The first case was a clean-cut sharp amputation. The second case was an avulsion injury following a motor vehicle accident in a patient who arrived 8 hours after the injury. Replantation was successful in both cases. In avulsion injuries, a secondary operation for wound coverage is required at a later stage. With good strategy and a support team, encouraging limb survival outcomes are possible post-replantation.

Keywords: Amputation; Lower extremity; Replantation; Traumatic.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.. Sword-inflicted amputation of the left ankle
(A) Preoperative view of amputation at the level of the tibiotalar joint. (B) Immediate postoperative X-rays showing good alignment of the bones with rush rods in situ. (C, D) At 30 days postoperatively, the medial aspect had healed primarily. The lateral aspect had healed secondarily.
Fig. 2.
Fig. 2.. Traumatic amputation of right leg
(A, B) Amputation at the level of the tibiotalar joint. Markings showing the tibial nerve and anterior tibial artery. (C) After bone shortening, replantation and microsurgical neurovascular repair were completed. Additional stabilization was performed with an external fixator.
Fig. 3.
Fig. 3.. Wound edge necrosis at 10 days post-replantation
(A) Wound necrosis demarcation. (B) The wound was debrided and covered with a free anterolateral thigh flap. (C) Good viability at 6 weeks after free flap wound coverage.
See this image and copyright information in PMC

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