Shrinkage of the below-knee stump in leprosy.

The long-term progress of below-knee stumps was studied in 65 leprotic amputees. Thirty-seven patients underwent amputation with a long posterior flap (LP) and 28 patients with an equal anterior and posterior flap (EF) technique. Mean follow-up was for 6 and 7 years respectively. Shrinkage of the soft tissue and retraction of the posterior calf muscles caused the posterior skin flap of the stump to rotate posteriorly in all cases, with a mean 26 degrees of rotation in LP stumps and 42 degrees of rotation in EF stumps. The LP stumps remained thicker, with soft tissue padding at the bony ends, and had fewer stump complications than the EF stumps.