What can be done to salvage a
limb after severe injury to the posterior compartment of the patient’s lower
leg? If there is neurovascular compromise to the limb, below the knee
amputation is recommended as the best treatment option. If there is viable circulation
present in the posterior compartment
a salvage procedure might be done especially if the patient refuses a below
the knee amputation.
In this case the surgeon repaired
what he could after determining most of the Achilles tendon was damaged beyond
repair but part of the gastro-soleus muscle belly was intact. The patient
states he had four operations with the last several procedures skin grafts to
cover the remaining defects. Eventually his lower leg healed a year later.
What remained of his leg was a
toe walking patient who used a cane most of the time to walk and on occasion crutches.
He was never able to play baseball, run and jump after the injury which he
regretted. He eventually got married and had several children who are now
adults and who also have children.
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