SUCCESSFUL REPLANTATION OF A TRAUMATIC BILATERAL LOWER LIMB AMPUTATION IN MALAYSIA, A CASE REPORT

Abstract

Bilateral replantation of the lower limbs following a traumatic total amputation are not commonly reported. We present a successful replantation of bilateral lower limbs following a traumatic total below knee amputation in a 30-year-old patient. The ischaemic time was more than six hours, and we only manage to fix the bone and perform neurovascular anastomosis and reconstruction with the help of bypass perfusion prior to the replantation. After the surgery, the right replanted limb had necrotizing fasciitis, which was debrided leaving huge soft tissue defect which was covered with a free myocutaneous Latissimus Dorsi flap. A year after the first operation, our patient can stand on his own and ambulate with support proving that our surgery can still provide functionality to the patient in terms of ambulation. In conclusion, with the advances of microsurgery and reconstructive field, limb salvage of amputated bilateral lower limb even with residual functionality should be attempted.

Keywords: Bilateral lower limb replantation, bilateral below knee traumatic amputation, extracorporeal membrane oxygenation, Latissimus dorsi flap.