A series of microsurgical free flap reconstructions to amputation stumps of the upper as well as lower extremity was reviewed in 7 male and 2 female patients. Indications included preservation of length after trauma in 6 cases and cure of local infection in 2 cases. In one case an extensive defect created by resection of a recurrent shoulder sarcoma required use of an arm fillet flap for palliative soft tissue reconstruction. The types of microvascular free flaps used were 4 scapular flaps, 2 fillet flaps from an amputated extremity, 1 anterolateral thigh flap, and 1 lateral arm flap. Seven of nine patients were fitted with prostheses and underwent occupational therapy resulting in ambulatory or functional status. Microvascular reconstruction is indicated in emergency settings as well as for elective reconstruction of amputation sites. The use of uninjured "spare parts" of the amputated extremity should be considered. Elective reconstruction is prefrably performed with free flaps based on the subscapular vascular system.
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