A Case Report Of 19 Years Follow-up After The Double-foot Replantation

Objective: To summarize and report the the double-foot replantation and clinical effect of functional recovery.Methods: On February 26,1998 we were Successful completion of A case of the double-foot replantation.We followed up the patients at their home on January 7,2017 and evaluated the function,Postoperative functions were evaluated using the zhong-wei Chen(1984).Results: After 19 years,the patients and their families were satisfied with the appearance and function of the feet.The reattachment of both feet is atrophied,and the atrophy of the right foot is clearly atrophy on the left foot.Right foot moderate atrophy,deformity is more obvious,replantation site has a few scar tissue hyperplasia.The skin color is darker,the outside of the foot is callous,and the third and forth toes of the right foot are severely atrophic.The skin thickened and bursa were not touched on the medial side of the foot,without obvious tenderness.There was no obvious tenderness between the medial malleolus and Achilles tendon,and the posterior tibial artery was slightly weak,and there was no obvious tenderness in the back of the foot.The dorsal artery beats slightly.The skin is very tight.The heel length is about 15 cm long.Ankle mobility: back stretch 3 °,plantar flexion 30 °;Subtalar joint mobility: evaginate 0 °and 5 °varus.Patients with foot flexor and extensor muscle strength grade 4,with low skin temperature and prickling pain,two points of discrimination were not detected,and two points of identification were measured on the ankle joint of about 5cm.No pathological reflection exists.Left foot mild atrophy,scar tissue formation is less,the skin color returns to normal.The skin thickened and bursa were not touched on the medial side of the foot,without obvious tenderness.There was no obvious tenderness between the medial malleolus and Achilles tendon,and the posterior tibial artery was slightly weak,and there was no obvious tenderness in the back of the foot.The dorsal artery beats slightly.The skin is tight;The dorsal artery beats medium.The skin is very tight.The heel length is about 18 cm long.Ankle mobility: back stretch 5 °,plantar flexion40 °;Subtalar joint activity: 30 °and 25 ° varus.Patients with foot flexor and extensor muscle strength grade 4,with low skin temperature and prickling pain,two points of discrimination were not detected,and two points of identification were measured on the ankle joint of about 5cm.There is no pathologic reflex.The activity of the two feet was normal,and the activity of the remaining toes was poor.According to the evaluation criteria for the replantation of severed limb in Chen zhongwei(1984),1 year after surgery was excellent,and 19 years after surgery was good.Conclusion: Replantation is an effective method for the treatment of foot dissection,and the postoperative positive standard rehabilitation is an effective method to obtain the best function.