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Published in: HSS Journal ® 1/2016

01-02-2016 | Case Report

Lengthening of Tibia after Trans-Tibial Amputation: Use of a Weight Bearing External Fixator-Prosthesis Composite

Authors: Aaron Lam, BA, Glenn Garrison, CPO, S. Robert Rozbruch, MD

Published in: HSS Journal ® | Issue 1/2016

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Excerpt

When a patient encounters a traumatic injury to his or her lower limb, limb salvage is not always possible and amputation may be required. Other indications for amputation include tumor and peripheral vascular disease. There are major advantages to maintaining a trans-tibial amputation (TTA) and not converting to a trans-femoral amputation (TFA). Lower levels of amputation lead to better clinical outcomes due to preservation of the knee joint and the mechanics of standing and walking. While all amputations require increased energy for walking, there is better energy efficiency with a TTA (15–45% above normal) than a TFA (25–65% above normal). Other advantages of TTA over TFA include better ability to negotiate environmental barriers, better balance, better proprioception, better control of the prosthesis, and improved gait [14]. When possible, TTA is preferable to TFA. …
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Literature
1.
go back to reference Ali MM, Loretz L, Shea A, et al. A contemporary comparative analysis of immediate postoperative prosthesis placement following below-knee amputation. Ann Vasc Surg. 2013; 27: 1146-1153.CrossRefPubMed Ali MM, Loretz L, Shea A, et al. A contemporary comparative analysis of immediate postoperative prosthesis placement following below-knee amputation. Ann Vasc Surg. 2013; 27: 1146-1153.CrossRefPubMed
2.
go back to reference Bowen RE, Struble SG, Setoguchi Y, Watts HG. Outcomes of lengthening short lower-extremity amputation stumps with planar fixators. J Pediatr Orthop. 2005; 25: 543-547.CrossRefPubMed Bowen RE, Struble SG, Setoguchi Y, Watts HG. Outcomes of lengthening short lower-extremity amputation stumps with planar fixators. J Pediatr Orthop. 2005; 25: 543-547.CrossRefPubMed
3.
go back to reference Carvalho JA, Mongon MD, Belangero WD, Livani B. A case series featuring extremely short below-knee stumps. Prosthet Orthot Int. 2011; 36(2): 236-238.CrossRefPubMed Carvalho JA, Mongon MD, Belangero WD, Livani B. A case series featuring extremely short below-knee stumps. Prosthet Orthot Int. 2011; 36(2): 236-238.CrossRefPubMed
4.
go back to reference Gailey RS, Wenger MA, Raya M, et al. Energy expenditure of trans-tibial amputees during ambulation at self-selected pace. Prosthet Orthot Int. 1994; 18: 84-91.PubMed Gailey RS, Wenger MA, Raya M, et al. Energy expenditure of trans-tibial amputees during ambulation at self-selected pace. Prosthet Orthot Int. 1994; 18: 84-91.PubMed
5.
go back to reference Mertens P, Lammens J. Short amputation stump lengthening with the Ilizarov method: risks versus benefits. Acta Orthop Belg. 2001; 67: 274-278.PubMed Mertens P, Lammens J. Short amputation stump lengthening with the Ilizarov method: risks versus benefits. Acta Orthop Belg. 2001; 67: 274-278.PubMed
6.
go back to reference Orhun H, Saka G, Bilgic E, Kavakh B. Lengthening of short stumps for functional use of prostheses. Prosthet Orthot Int. 2003; 27: 153-157.CrossRefPubMed Orhun H, Saka G, Bilgic E, Kavakh B. Lengthening of short stumps for functional use of prostheses. Prosthet Orthot Int. 2003; 27: 153-157.CrossRefPubMed
7.
go back to reference Pant R, Younge D. Turn-up bone flap for lengthening the below-knee amputation stump. J Bone Joint Surg (Br). 2003; 85-B: 171-173.CrossRef Pant R, Younge D. Turn-up bone flap for lengthening the below-knee amputation stump. J Bone Joint Surg (Br). 2003; 85-B: 171-173.CrossRef
9.
go back to reference Savage Z, Munjal R. Multidisciplinary team approach to residual limb lengthening using the Ilizarov technique: a case study. Prosthet Orthot Int. 2014. Savage Z, Munjal R. Multidisciplinary team approach to residual limb lengthening using the Ilizarov technique: a case study. Prosthet Orthot Int. 2014.
11.
go back to reference Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR. Lengthening and reconstruction of congenital leg deficiencies for enhanced prosthetic wear. Clin Orthop Relat Res. 2008; 466: 495-499.PubMedCentralCrossRefPubMed Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR. Lengthening and reconstruction of congenital leg deficiencies for enhanced prosthetic wear. Clin Orthop Relat Res. 2008; 466: 495-499.PubMedCentralCrossRefPubMed
12.
go back to reference Tooms RE. Chapter 19: amputations of lower extremity. In: Crenshaw AH, ed. Campbell’s operative orthopaedics. 8th ed. St. Louis: Mosby-Year Book, Inc; 1992: 689-702. Tooms RE. Chapter 19: amputations of lower extremity. In: Crenshaw AH, ed. Campbell’s operative orthopaedics. 8th ed. St. Louis: Mosby-Year Book, Inc; 1992: 689-702.
13.
go back to reference Villarruel G. Temporary prosthetic fitting over tibial stump lengthening device. J Prosthet Orthot. 2003; 15: 113-117.CrossRef Villarruel G. Temporary prosthetic fitting over tibial stump lengthening device. J Prosthet Orthot. 2003; 15: 113-117.CrossRef
14.
go back to reference Waters RL, Perry J, Antonelli D, Hislop H. Energy cost of walking of amputees: the influence of level of amputation. J Bone Joint Surg Am. 1976; 58: 42-46.PubMed Waters RL, Perry J, Antonelli D, Hislop H. Energy cost of walking of amputees: the influence of level of amputation. J Bone Joint Surg Am. 1976; 58: 42-46.PubMed
15.
go back to reference Younge D, Dafniotis O. A composite bone flap to lengthen a below-knee amputation stump. J Bone Joint Surg (Br). 1993; 75-B: 330-331. Younge D, Dafniotis O. A composite bone flap to lengthen a below-knee amputation stump. J Bone Joint Surg (Br). 1993; 75-B: 330-331.
Metadata
Title
Lengthening of Tibia after Trans-Tibial Amputation: Use of a Weight Bearing External Fixator-Prosthesis Composite
Authors
Aaron Lam, BA
Glenn Garrison, CPO
S. Robert Rozbruch, MD
Publication date
01-02-2016
Publisher
Springer US
Published in
HSS Journal ® / Issue 1/2016
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-015-9463-7

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