Troubleshooting a Difficult Trans-Tibial/Fibula Amputation: A Case Report
- 1 Department of Podiatry, Valleywise Health Medical Center, Phoenix, Arizona, USA
- 2 Department of Surgery Arrowhead Medical Center, Glendale, Arizona, USA
- 3 Department of Surgery, Mountain Vista Medical Center, Mesa, Arizona, USA
- 4 Valleywise Health Medical Center, Phoenix, Arizona, USA
- 5 Department of Podiatry, Valleywise Health Medical Center, Phoenix, Arizona, USA
- 6 Department of Podiatry, Valleywise Health Medical Center, Phoenix, Arizona, USA
- 7 Department of Surgery, Division of Trauma Surgery/Surgical Critical Care, The University of Texas Health Science Center, Tyler, Texas, USA
- 8 Department of Surgery, Weill Cornell Medical Center, New York, NY, USA
- 9 Department of Surgery, Banner University of Arizona/University Medical Center, Tucson, Arizona, USA
- 10 School of Medicine Bill Barrett Endowed Chair in Trauma Surgery, The University of Texas-Tyler, Tyler, Texas, USA
- 11 Trauma Wound Care, UT Health East, Tyler, Texas, USA
- 12 Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- 13 Department of Medicine and Nursing, University of Texas, Arlington, Texas, USA
- 14 Past Commanding General TXSG Medical Brigade, Austin, Texas, USA
- 15 Department of Surgery, New York Presbyterian Hospital, New York, NY, USA
Abstract
Necrotic feet secondary to vascular compromise in the diabetic patient may require an emergent guillotine amputation. Unrecognized, retained hardware in a distal ankle years after fracture repair may complicate the intraoperative guillotine amputation at the transtibial/fibula level. Troubleshooting such an unexpected surgical problem is not necessarily straightforward depending on the clinical situation. Presented is a case report where a patient with a necrot ic burned foot failed to inform the burn team that he had implanted ankle hardware, prior to his surgical intervention. A successful amputation was completed after proceeding down a specific algorithm devised for such a scenario.
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