Abstract
Background: Van Nes Rotationplasty (VNRP) is a biological reconstructive surgical method for pediatric sarcoma, complex trauma or severe lower limb deficiencies that often gets overlooked due to cosmetic reasons and psychological aspects. We report a unique case of knee stiffness and severe scarring from burns treated with this technique in a young patient who had also amputated contralateral femur. Case Report: A 15-year-old boy was trapped in a fire 10 years ago and sustained extensive contractures on his left knee due to severe burns and also an above knee amputation on his right thigh. For 10 years the boy had never received rehabilitation or worn any prosthesis and he managed to move bearing mainly on his palms. On admission to our hospital Van Nes rotationplasty was preferred among other treatment options as the most suitable solution for him and was successfully performed without complications. The patient had severe stiffness on his right hip and decreased muscle power in the VNRP leg but after intensive physiotherapy he was able to stand upright and walk again using custom made bilateral prostheses and crutches. Conclusion: VNPR is a reasonable option in severe contractures and scarring of the knee joint.
Highlights
Van Nes Rotationplasty (VNRP) is a biological reconstructive surgical method for pediatric sarcoma, complex trauma or severe lower limb deficiencies that often gets overlooked due to cosmetic reasons and psychological aspects
VNPR is a reasonable option in severe contractures and scarring of the knee joint
Van Nes Rotationplasty (VNPR) is a surgical procedure consisting of limb-saving shortening of the leg with a rotation of 180o of the lower leg which is adapted to the remaining femur, changing the ankle function into a new knee joint [1]
Summary
Van Nes Rotationplasty (VNPR) is a surgical procedure consisting of limb-saving shortening of the leg with a rotation of 180o of the lower leg which is adapted to the remaining femur, changing the ankle function into a new knee joint [1]. The functional outcome of such a technique is that the knee flexion corresponds to the former ankle dorsiflexion and the knee extension to the former ankle plantar flexion [2]. In order for this surgery to be performed the ankle should be in optimum condition prior to the procedure and the sciatic nerve should remain fully functional [3]. We report a unique case of VNRP applied to a 15-year-old boy due to severe burn contractures of his left knee; having his right leg amputated, he was unable to walk for more than 10 years but he managed to walk using bilateral custom-made prostheses and crutches
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