Severely injured leg!

Severely injured leg!

This is a traumatic below-knee amputation of the right lower limb following a road traffic accident.

Unfortunately, these injuries remain common, particularly following explosions and motor vehicle accidents, and, in addition, many survivors require primary amputation for unsalvageable injuries or to save their life.

Notice that a thigh tourniquet was applied to control bleeding at the field before arriving at the emergency department for surgery.

Further exploration revealed that all major nerves and vessels supplying the foot had been severed. The decision was then made to proceed with a formal, below-knee surgical amputation.

The limb was then covered with a soft dressing, and the knee was held in full extension with a long leg splint that supported the distal end and secured the knee anteriorly and posteriorly.

It was then primarily closed following debridement of any residual necrotic tissue and foreign materials.

The quality of the soft tissue envelope of the residual limb is important, as this provides the comfort and durability needed for prosthetic tolerance and weight-bearing. A painful, non-healing, residual leg secondary to inadequate soft tissue cover will markedly worsen physical disability.