Salvage surgery in foot and ankle pathology. A multidisciplinary approach

Abstract

[eng] Introduction: The amputation of a limb should be the last choice in severe foot and ankle pathology. We describe a series of patients with large bone and soft tissue defects and severe sequelae of foot and ankle pathology treated using a multidisciplinary approach, where we performed salvage surgery. Methods: We present eight cases of patients with severe seque- lae of pathology of the foot and ankle, six men and two women. The pathologies were very different: severe polytraumathized, osteomyelitis. Study together with plastic surgery, infectious inter- nal medicine and vascular surgery was performed. The median follow-up was two years. The eight patients were operated by the same specialists. Results: In seven of the eight patients salvage surgery results were very good, in a patient evolution was unfavorable and transtibial amputation was performed. In seven patients with good results, we get a non-painful, plantigrade foot. One of them walks without calcaneal. The patients were able to increase the results with the AOFAS scale, but most importantly, was to avoid amputa- tion in seven patients. Conclusion: Amputation is not always the best for the patient. To maintain a functioning, non-painful and plantigrade foot-ankle is, at times very difficult. We believe it is our duty to give every pos- sible opportunity and fight to the end to save the lower extremity. In complex pathology of foot and ankle, with severe bone and soft tissue defects, we should refer to a specialized multidisciplinary unit. Salvage surgery, with good planning and a good multidisci- plinary team surgery is a very good option to avoid amputation.