Gritti-Stokes Amputation in the Trauma Patient: Tips and Techniques.

Introduction: The Gritti-Stokes amputation establishes osseous continuity between the patella and the distal part of the femur with maintenance of the intact prepatellar soft tissues.

Step 1 Preoperative Planning: As with all orthopaedic surgery, preoperative planning is essential to obtaining an optimal outcome with this procedure.

Step 2 Flap Design: Use an asymmetric flap consisting of the undisturbed prepatellar soft tissues and rotate it posteriorly to achieve closure.

Step 3 Soft-tissue Dissection: Keep soft-tissue dissection subperiosteal or intratendinous to minimize blood loss and postoperative pain.

Step 4 Distal Femoral And Patellar Cuts: Use a high-speed saw to transect the femur and patella.

Step 5 Posterior Dissection: Carry out posterior dissection in a methodical manner, with individual identification and ligation of all neurovascular structures.

Step 6 Patellofemoral Arthrodesis: Suture the patella to the distal part of the femur using six drill holes and nonabsorbable suture.

Step 7 Soft-tissue Closure: Close the remaining soft tissue, including the posterior musculature, subcutaneous layer, and skin, in a layered fashion.

Step 8 Postoperative Management: Postoperative care should be done in conjunction with a prosthetist to obtain optimal outcomes.

Results: The Gritti-Stokes amputation technique appears to be a potentially valuable addition to the amputation surgeon's armamentarium.

What To Watch For: IndicationsContraindicationsPitfalls & Challenges.