Colgajo libre fileteado de pie para salvamento de la rodilla en una amputación traumática de miembro inferior. caso clínico / Foot fillet flap for knee salvage in traumatic amputation of the lower leg. A case report

Las indicaciones de reimplante en las amputaciones traumáticas del miembro inferior son muy discutibles; sin embargo, el empleo de partes no reimplantables para reconstruir el muñón es una técnica quirúrgica bien establecida. Se presenta un caso de amputación traumática de miembro inferior por el tercio proximal de tibia tratada mediante cobertura del muñón con un colgajo microvascular fileteado reinervado del pie amputado para conservar la articulación de la rodilla. El paciente consiguió adaptar una prótesis infracondílea (AU)

Centrocentral anastomosis of the proximal nerve stump in the treatment of painful amputation neuromas of major nerves.

The term "centrocentral anastomosis" is used to describe the end-to-end connection across interposed nerve grafts between paired fascicular groups of the proximal stump of a severed nerve. In 22 patients harboring a painful terminal neuroma following amputation of a lower limb (20 neuromas on the sciatic nerve and two on the peroneal nerve), a centrocentral anastomosis was performed on the end of the sectioned nerve to treat pain that had not improved with conventional conservative treatment. Follow-up review at 1 year revealed that the typical neuroma pain had disappeared in all cases, although sporadic diffuse pain persisted in four. Where previous phantom sensation was present, no change was observed. The results presented here are consistent with laboratory findings demonstrating the absence of neuroma formation after centrocentral anastomosis. Therefore, this technique is recommended for the treatment of painful amputation neuroma.