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.
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