[Cross replantation in a case of bilateral amputation of the legs]

Abstract

A case is reported of a patient aged 32 years who suffered bilateral traumatic amputation of the legs by a wagon. Neither of his two feet could be re-implanted to its original site. In spite of the severity of the lesions, reconstructive surgery was attempted by crossed re-implantation of the right foot onto the stump of the left leg. After bony shortening by 20 cm and internal fixation of the tibia, revascularisation was achieved by suture of the posterior tibial vascular pedicle. Primary repair of the posterior tibial nerve allowed protective sensibility to recover in the sole of the foot. Secondarily, a free musculo-cutaneous graft from the latissimus dorsi improved skin cover. Bony union occurred after 10 months. Prolonged rehabilitation resulted in satisfactory walking and activities of daily living and a return to work 18 months after the accident.