Reconstruction of the heel pad in ankle disarticulation with a free muscle transfer.

An otherwise healthy 17-year-old young man developed bilateral heel pad necrosis due to meningococcemia, adult respiratory distress syndrome, and disseminated intravascular coagulation. Bilateral ankle disarticulation amputations were salvaged by use of a dorsally based local flap on one residual limb and a free muscle transfer to reconstruct the weight-bearing surface of the contralateral residual limb. The case report illustrates two methods of unusual salvage of the end-bearing, weight-bearing surface of the residual limbs in a bilateral end-bearing amputation.