Dr. Ekansh Debuka - Orthopedic Surgeon

Limb salvage is not complete until the limb is functional. This 19-year-old gentleman had sustained a devastating crush injury to his lower limb, requiring multiple debridements, external fixation, free-flap reconstruction and eventually a tibiotalocalcaneal (TTC) fusion to salvage the limb. The fusion united and the limb survived—but he was left with a severe, rigid deformity of the midfoot and forefoot. With the ankle and subtalar joints fused into a single rigid block, he had to hyperextend his knee simply to bring the heel and forefoot onto the ground. Rocker soles and customized insoles failed to provide adequate correction. Rather than disturbing a successfully united TTC fusion, we chose to correct the deformity at its apex. An apex-based corrective midfoot osteotomy with arthrodesis and internal fixation was performed while carefully preserving the previously reconstructed soft-tissue envelope and retaining the existing TTC nail. The objective wasn't a perfect X-ray. It was a plantigrade, stable foot that could allow the entire limb to function more normally. The immediate correction is encouraging. The next milestones are wound healing, union, maintained correction and, most importantly, how he walks once weight bearing resumes. Because saving a limb is one thing. Making it useful is the real goal. #LimbSalvage #FootAndAnkle #Orthopaedics #LimbReconstruction #DeformityCorrection 15 hours ago