Fig. 2.

66 year-old female patient with FRI after open reduction and internal plate fixation distal fibula fracture, end-stage peripheral artery disease and consecutive concomitant PJI of the hip. A X-ray of the pelvis with revision endoprosthesis prior to explantation (a.p. view). Puncture revealed vancomycin-resistant Enterococcus faecalis. B Postoperative X-ray after implantation of a PMMA spacer. Below knee amputation was indicated due to severe ankle osteomyelitis and lateral soft tissue defect. C Image after below knee amputation. D CT scout after below knee amputation. E Infection of the amputation stump after three months. F Intraoperative image after debridement. Due to persistent wound infection and soft tissue defect hip discarticulation was performed. G Postoperative X-ray after hip disarticulation