Standard and non-standard LL amputations, by Keith Jones.

Amputations, by Keith Jones

Good talk.

Gave plenty of historial background

Mentioned Burgess

Then the European modification of the long posterior flap - Bruckner

Talked about Kingsley Robinson who sadly died in 1991, the originator of the skew flap

Emphasised that in the KR skew it was only the skin flap that is skewed; not the muscle

Mentioned another BKA reconstruction technique which DOES skew the muscle flap; that’s a different one.

Then spoke of something called the Ertl. I haven’t encountered that before.

Proceeded to talk about minor amputations.

Helpful point about the axis of the foot being around the 2nd toe and MT. And that therefore when doing a TMTA, the hallux 1st MT should be bevelled inner (medially) and that the 3,4,5 should be bevelled on the lateral side, and that all should be bevelled on the plantar aspect

Nice images and descriptions of this being done with great attention to all the above detail (in case of TMTA) by ortho foot and ankle colleagues in Frimley.

Favours the Symes.

Would not do a Chopart.

Says if faced with the potential need for a Chopart, to instead choose between either a Symes or a BKA.

States that getting the flap and excision (removal of the calcaneum through the access wound without damaging what is left behind) is one of the most challenging operations that KJ does. Makes him sweat.