Lower Limb Reconstruction

Soft tissue flap reconstruction restores soft tissue coverage, protects underlying structures, and promotes wound healing.

• Local flaps use adjacent tissue to cover smaller wounds on the foot, ankle, or knee, preserving function with minimal disruption.
• Pedicled flaps maintain their original blood supply and are often used for larger wounds in the lower leg.
• Free flaps (microsurgical flaps) transfer muscle, skin, and fat from areas like the anterolateral thigh (ALT), latissimus dorsi, or rectus abdominis, requiring microsurgical blood vessel reconnection for successful integration.

Bone grafting repairs structural defects, restoring stability and weight-bearing function in the lower limb.

• Autografts use bone harvested from the pelvis, rib, or fibula, containing live bone-forming cells for optimal integration.
• Allografts, sourced from donors, are used for large-scale reconstructions, though they integrate more slowly.
• Vascularised bone grafts, such as fibula-free flaps or iliac crest grafts, include an intact blood supply, ensuring faster healing, greater strength, and long-term durability.

Tendon and nerve reconstruction is required for restoring movement and sensation in patients with severe nerve damage or tendon loss.

• Tendon transfers redirect a functioning tendon to replace a damaged one, allowing for restored mobility and joint function.
• Nerve grafting involves transferring healthy nerve tissue to repair damaged nerves, promoting sensory recovery and motor function improvement over time.

Skin grafting is used to close large wounds, burns, or chronic ulcers, promoting healing and reducing infection risk to help prevent amputation.

• Split-thickness skin grafts cover large surface wounds, providing a protective barrier while promoting tissue regeneration.
• Full-thickness skin grafts are used in areas needing greater durability and contour matching, ensuring better aesthetic and functional outcomes.

Limb lengthening and deformity correction help restore proper alignment, stability, and function in patients with limb shortening or misalignment.

• The Ilizarov technique uses an external fixator to apply controlled tension, gradually stimulating new bone formation and increasing limb length.
• Corrective osteotomies involve precise bone cutting and repositioning to realign malunited fractures or congenital deformities, improving joint positioning and walking mechanics.

Swelling, bruising, and discomfort are common in the first few days to weeks following surgery. Pain management includes prescribed medications and limb elevation to reduce swelling and promote circulation.

In the first two weeks, initial swelling subsides, and surgical wounds begin healing. By four to six weeks, patients can resume light activities, but weight-bearing remains limited to allow for proper bone and tissue healing. Over three to six months, bone and soft tissue healing stabilises, and rehabilitation therapy helps restore mobility, strength, and function, ensuring gradual recovery and improved limb use.

To support healing, patients should avoid high-impact activities for at least four to six weeks to prevent complications. Keeping the limb elevated and using compression garments as prescribed can help manage swelling and circulation. Rehabilitation therapy helps regain mobility, strength, and flexibility, ensuring the best possible functional outcome.