Prosthesis-free solution for below-knee amputations

The Ilizarov fixator can be used as a bone regenerator to correct limb-length discrepancies in patients who require limb lengthening.A 17-year-old man presented with 12 cm of left lower-limb shortening and amputation at the left mid-forefoot region, which was the result of severe burns of the left lower limb at 2 years of age. The burns damaged the distal femoral, proximal, and distal tibial physes. Scarring around knee and leg acted as a bowstring and slowed normal longitudinal femoral and tibial bone growth. The patient wished to be prosthesis free. Limb lengthening was performed with the Ilizarov fixator. The patient became prosthesis free and was able to perform activities of daily living wearing normal footwear, which was possible because the patient had a good heel pad. The patient can walk on a normal limb with no prosthesis, the significant advantage being the right proprioceptive feedback it gives the patient during ambulation because it is sensate.This technique can be used in other patients with below-knee amputations in which the tibial amputated end can be given a myoplasty cover or padding nearly as good as a heel. Subsequently, tibiae can be lengthened, and patients can be made to bear weight on artificial heels.