Purpose: Despite advancements in reconstructive techniques, lower limb amputations remain a common outcome of lower limb trauma. The primary aim of amputation is to create a functional, sensate, and pain-free stump whilst preserving maximal limb length possible. The foot is a valuable source of tissue that is frequently distal to the zone of trauma and is otherwise discarded in traditional amputations. It offers robust, sensate and well-vascularised coverage for amputation stumps. Key options include the fillet-of-sole flap, which consists of the durable glabrous skin, plantar muscles, and fascia, and the complementary dorsal foot flap, made of soft tissue from the dorsal foot. While these flaps have been described in the literature, their application remains underutilised and there exists no established decision-making framework for these flaps in the context of leg amputation. We present our experience with the 'spare-parts' concept in lower limb reconstruction through an illustrative case series and propose an algorithm aimed at optimising residual limb length and sensibility. Methodology: A retrospective, multi-centre review was conducted across three tertiary hospitals on patients who underwent lower limb amputation stump reconstruction using salvaged tissue from 2022 to 2024. Results: Three male patients, aged 20-27, were included: one with an above-knee amputation and two with below-knee amputations due to motor-related trauma. One free and three pedicled fillet-of-sole flap reconstructions were performed. All flaps remained healthy and sensate throughout the follow-up period. Based on these cases, a pragmatic decision-making algorithm was developed to guide management in future presentations. Conclusion: Foot flaps are a viable option for reconstructing traumatic lower limb amputations. Developing a protocol based on vascular integrity and zone of trauma can improve outcomes by tailoring techniques to specific clinical situations.

Background: Large segmental femoral defects following high-energy trauma present a major reconstructive challenge. Options include bone transport, induced membrane (Masquelet) techniques, and vascularised bone transfer, each limited by defect size, treatment duration, and morbidity. Within vascularised reconstruction, strategies include single, double-barrel, or multiple fibula constructs. Optimal management requires orthoplastic collaboration and careful strategy selection. We describe a multidisciplinary approach using double free fibula transfer with virtual surgical planning (VSP) for definitive reconstruction of a complex post-traumatic femoral defect. Methods: A 28-year-old man sustained polytrauma including an open midshaft femoral fracture with 8–12 cm segmental bone loss. Initial intramedullary fixation and cement spacer placement was followed by soft tissue coverage with a contralateral anterolateral thigh (ALT) free flap. Given defect length, geometry, and prior reconstruction, bone transport, Masquelet, and double-barrel fibula were deemed suboptimal. VSP guided design of two independent free fibula flaps, inset as medial and lateral vascularised struts with custom plates. The existing ALT pedicle served as recipient vessels; one flap was anastomosed directly, the second as a flow-through flap. Results: The double free fibula construct restored femoral continuity and stability while preserving soft tissue coverage. Microsurgical anastomoses were completed without complication, and early postoperative assessment confirmed flap viability and stable fixation. Conclusion: Double free fibula transfer, facilitated by VSP and innovative recipient vessel strategies, provides a reliable alternative when bone transport, induced membrane techniques, or double-barrel fibula are unsuitable. This case highlights the value of staged orthoplastic collaboration and strategic decision-making in complex limb salvage.