Usefulness of fasciocutaneous flaps for revision of below-knee amputation stumps

Abstract Below-knee lower limb amputations are commonly performed for multiple indications. These vary across age groups, with trauma being the most common indication among young adults. Although below-knee amputations are disabling, decent functional outcomes can be expected with an adequately long tibial stump and a good prosthesis. In our series, the amputation stump was debrided per the surgeon’s clinical judgement. The fasciocutaneous flap (free or pedicled) was planned according to the patient’s individual needs and the flap’s feasibility at the surgeon’s discretion. A fasciocutaneous flap cover helps preserve the length of the below-knee amputation stump, resulting in better ambulation. A flap cover at the amputation stump is a better alternative to revising the level of amputation. Higher-level amputations have much worse ambulation rates and require more energy for efficient ambulation with prosthesis.