calf amputation

The calf truncation is aimed at the following conditions: 1. The primary malignant tumor of the limb should be amputated at an early high position. In the early stage of the disease, the lesion is limited to the bone. If there is no distant metastasis, the tumor segment can be resected and the distal limb replanted. 2. Severe infection of the limbs (such as uncontrollable gas gangrene), or suppurative infections that are uncontrollable by drugs and general surgery, complicated by severe sepsis, threatening the life of the patient. Those who are not amputated to save lives should be amputated in time. 3. Serious and extensive injuries to the limbs, those who cannot be repaired or replanted, must perform amputation immediately. 4. Due to arterial thrombosis, thromboangiitis, arteriosclerosis, diabetes and other reasons caused by insufficient blood supply to the limbs, there are obvious necrosis, should be amputated. 5. Congenital multi-finger (toe), can be cut off. 6. Severe deformity of the limb affects the function, while orthopedic surgery can not improve the function. After the amputation, the prosthetic can improve the function, and the amputation can be considered. Treatment of diseases: old rotten leg tibia distal burst fracture Indication 1. The primary malignant tumor of the limb should be amputated at an early high position. In the early stage of the disease, the lesion is limited to the bone. If there is no distant metastasis, the tumor segment can be resected and the distal limb replanted. 2. Severe infection of the limbs (such as uncontrollable gas gangrene), or suppurative infections that are uncontrollable by drugs and general surgery, complicated by severe sepsis, threatening the life of the patient. Those who are not amputated to save lives should be amputated in time. 3. Serious and extensive injuries to the limbs, those who cannot be repaired or replanted, must perform amputation immediately. 4. Due to arterial thrombosis, thromboangiitis, arteriosclerosis, diabetes and other reasons caused by insufficient blood supply to the limbs, there are obvious necrosis, should be amputated. 5. Congenital multi-finger (toe), can be cut off. 6. Severe deformity of the limb affects the function, while orthopedic surgery can not improve the function. After the amputation, the prosthetic can improve the function, and the amputation can be considered. Preoperative preparation 1. Amputation will bring severe mental and physical trauma to the patient. Therefore, the patient and his relatives should be explained in detail about the necessity of amputation and the problems in the assembly and use of the prosthesis. In the case of an open amputation, it is necessary to state that the amputation must be performed again. 2. Patients who are amputated after an open amputation are best to wait for the wound to heal after surgery; if they are not healed, they should be skin grafted first. 3. Except for those who have necrosis due to insufficient blood supply, all amputations should be placed on the proximal end of the truncated plane to inflate the tourniquet to reduce blood loss and keep the field clear. 4. In general, patients with high amputees should be prepared for blood transfusion before surgery to prevent shock. 5. Various special circumstances, such as diabetes, malignant tumors, etc., should be controlled with insulin or anti-tumor drugs before and after surgery. Surgical procedure 1. Position: supine position, slightly under the calf. 2. Incision: The design of the flap requires the above amputation. The scar of the incision should fall on the posterior side of the stump. The flap should be short before and long, and the anterior flap should be 1 cm long. Cut the skin along the entire layer of the incision and flip the flap to the plane of the amputation. 3. Cut off the anterolateral tissue of the calf: ligation and cutting of the great saphenous vein in the truncated plane. The anterior tibial vessels and the deep peroneal nerve were separated between the anterior muscle and the long toe of the toe; the superficial peroneal nerve was found between the short musculature and the long toe of the toe, and the muscle was cut off according to routine cutting. 4. Osteotomy: The ideal truncated plane of the calf is 13 cm below the tibial plateau. The following two methods can be used to determine: when the anterior flap is incision, the periosteum is cut at the lowest point to the periosteum in front of the tibia, and the trace is drawn, thereby measuring upward; or downward from the anterior inner edge of the tibial plateau. The humerus was cut in the design plane, and the tibia was cut at a height of 3 cm above the tibia. The diseased limb can be broken. 5. Treatment of posterior iliac vessels and nerves: The posterior tibial muscles were divided into posterior tibial vessels, nerves and iliac vessels, which were treated as usual. Loosen the tourniquet and stop the bleeding completely. 6. Treatment of the bone end: The treatment of the bone end in the leg amputation has its particularity. The humerus is triangular in shape. In order to prevent the subcutaneous bone from protruding, the skin is pressed, and part of the bone is to be chiseled at the leading edge of the tibia. For the shorter calf residual limb, the upper part of the humerus should be removed and the excess muscle removed to accommodate the prosthetic assembly. The sharp end of the broken end of the bone is flattened. 7. Stitching: Rinse the wound, check for no bleeding. After the flap is suitable, the rubber sheet is drained and sutured layer by layer.