Use of the Sole Flap to Convert an Above Knee Amputation to a Below Knee Amputation in Trauma.

Dear Editor, An amputation is often a better option in patients with severe lower limb trauma when the prognosis of a limb salvage procedure is not ideal. It also minimises morbidity and mortality.1 The level of amputation is determined by the zone of injury and availability of soft tissue cover beyond the level of bone amputation. This means that patients with severe segmental injuries involving the leg often end up with an above knee amputation (AKA) or through knee amputation (TKA) instead of below knee amputation (BKA). We report 3 cases involving the use of sole fl aps (2 free fl aps and 1 pedicle fl ap) in segmental crush injuries to convert a potential AKA/TKA to a BKA by providing adequate cover for a below knee stump. The approach allows for knee joint salvage and increased stump length. Although the use of sole fl aps to achieve better soft tissue cover in BKAs have been reported,2-8 the authors revisit this subject with a series of 3 case reports, and discuss the merits of the procedure and its effect on patient outcome in the shortand long-term.