{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T18:23:13Z","timestamp":1746728593872,"version":"3.37.3"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T00:00:00Z","timestamp":1676073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of \u201cspare parts\u201d in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed \u201clowering the level of the amputation\u201d from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying \u201cspare-parts\u201d surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.<\/jats:p>","DOI":"10.1055\/a-2033-5803","type":"journal-article","created":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T23:32:25Z","timestamp":1676158345000},"page":"501-506","source":"Crossref","is-referenced-by-count":2,"title":["Osteocutaneous Turn-Up Fillet Flaps: A Spare-Parts Orthoplastic Surgery Option for a Functional Posttraumatic Below-Knee Amputation"],"prefix":"10.1055","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8931-0992","authenticated-orcid":false,"given":"Harry","family":"Burton","sequence":"additional","affiliation":[{"name":"London Reconstructive Microsurgery Unit, Emergency Care and Trauma Division, Department of Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexios Dimitrios","family":"Iliadis","sequence":"additional","affiliation":[{"name":"Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8041-4013","authenticated-orcid":false,"given":"Neil","family":"Jones","sequence":"additional","affiliation":[{"name":"Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Saini","sequence":"additional","affiliation":[{"name":"Trauma and Limb Reconstruction Unit, Department of Trauma and Orthopaedics, King's College Hospital Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-0077","authenticated-orcid":false,"given":"Nicola","family":"Bystrzonowski","sequence":"additional","affiliation":[{"name":"Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9723-9533","authenticated-orcid":false,"given":"Alexandros","family":"Vris","sequence":"additional","affiliation":[{"name":"Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-277X","authenticated-orcid":false,"given":"Georgios","family":"Pafitanis","sequence":"additional","affiliation":[{"name":"London Reconstructive Microsurgery Unit, Emergency Care and Trauma Division, Department of Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom"},{"name":"Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom"},{"name":"Department of Medical Sciences, Medical School, University of Cyprus, Nicosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.2106\/00004623-200408000-00006","article-title":"Functional outcomes following trauma-related lower-extremity amputation","volume":"86","author":"E J MacKenzie","year":"2004","journal-title":"J Bone Joint Surg Am"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1177\/000313481508100618","article-title":"Early versus delayed amputation in the setting of severe lower extremity trauma","volume":"81","author":"Z F Williams","year":"2015","journal-title":"Am Surg"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1055\/s-0039-1695753","article-title":"Principles of orthoplastic surgery for lower extremity reconstruction: why is this important?","volume":"37","author":"S C Azoury","year":"2021","journal-title":"J Reconstr Microsurg"},{"issue":"256","key":"ref4","first-page":"76","article-title":"Amputation stump lengthening with the Ilizarov technique. 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