Rotationplasty.

Partial limb salvage by a rotationplasty procedure is possible in patients suffering from malignant tumors of the lower extremity. Upon diagnosis of a malignant tumor of the distal femur or proximal tibia, resection of the tumor is performed with wide margins, including the knee joint. The sciatic nerve is preserved, and the lower part of the leg is retransplanted to the thigh, observing a rotation of 180 degrees. This procedure results in a shortened leg with the ankle joint at the position of the former knee joint. The resulting stump is able to bear a prosthesis. The ankle rotated at 180 degrees serves as a substitute knee joint capable of moving a shank prosthesis, an ability which would have been lost with high amputation of the leg. The foot is able to carry load via the sole skin. There is no phantom pain. Experience with 40 cases is reported.