ePlasty: Vol. 20
The Functional Benefits of Preserving the Proximal Lower Leg Even in Total Necrosis of the Lower-Leg Muscles
Itaru Tsuge, MD, PhD,a Michiharu Sakamoto, MD, PhD,a Jun Arata, MD,b and Naoki Morimoto, MD, PhDa

aDepartment of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; and bDepartment of Plastic and Reconstructive Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan

Correspondence: itsuge@kuhp.kyoto-u.ac.jp
Keywords: amputation, gastrocnemius, lower leg, prosthetic leg, soleus


A 43-year-old man was introduced to us for the treatment of an infected wound after below-knee (B-K) amputation (Fig 1). Four months previously, he had experienced sudden cardiogenic shock and was transferred to the emergency department of another hospital. Under a diagnosis of fulminant myocarditis, percutaneous cardiopulmonary support (PCPS) from the right femoral artery was applied. His general condition gradually improved; however, PCPS caused right lower-limb ischemia and resulted in B-K amputation. After surgery, severe infection occurred and above-knee (A-K) amputation was recommended for an early cure. At the first visit to our hospital, contrast computed tomographic scan showed fluid accumulation at both the posterior and anterior tibias (Fig 2). We opened the s .......