The formation of a functional limb stump after combat injuries with extensive soft tissue damage is challenging. After amputations or revision surgeries, long femoral stumps may remain. Although functionally inferior to tibial stumps, they can still provide satisfactory movement and performance. However, prolonged prosthesis use or poor-quality muscle grafting can lead to complications, such as skin breakdown, trophic issues, and inability to continue prosthetic use. These problems are partly due to the mismatch between the area of the bone stump end and the applied body weight. Ilizarov compression-distraction osteosynthesis, radiographic assessment, and gait analysis before and after treatment using the GaitRite system. We describe a case of femoral stump reconstruction following a mine-blast injury. Prosthetic fitting was complicated by massive scars covering the bone fragments. A method was developed to expand the distal end of the femoral stump via distraction osteogenesis using the Ilizarov apparatus. This approach created a stable platform with a significantly larger bearing surface. For the first time, the bearing surface area was increased twofold, reducing soft tissue trauma and enhancing the load-bearing capacity of the prosthesis. The proposed reconstruction method significantly enlarges the distal femoral stump area, creates a mushroom-shaped end, decreases load per unit area, ensures even pressure distribution within the prosthetic socket, and improves the patient's functional outcome.
Bezsmertnyi et al. (Fri,) studied this question.