TITLE

Distal Tibiofibular. Bone-Bridging in Transtibial Amputation

AUTHOR(S)
Pinzur, Michael S.; Beck, Jennifer; Himes, Ryan; Callaci, John
PUB. DATE
December 2008
SOURCE
Journal of Bone & Joint Surgery, American Volume;Dec2008, Vol. 90-A Issue 12, p2682
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The creation of a bone bridge between the residual tibia and fibula is a controversial surgical technique used in the performance of transtibial amputation. Methods: Twenty consecutive patients who underwent a unilateral transtibial amputation, as a consequence of traumatic injury, had distal tibiofibular bone-bridging performed by a single surgeon. Eight completed the Prosthesis Evaluation Questionnaire (PEQ), a validated outcomes instrument designed to measure patient self-reported health-related quality of life after a lower-extremity amputation. Their responses were compared with those of a previously reported control group of nondiabetic patients who had undergone transtibial amputation with the use of a traditional technique and with those of a previously reported consecutive group of Brazilian patients, including twelve who were diabetic, who had undergone a similar bone-bridge procedure. Results: The scores in the American bone-bridge group were similar to those in the control group and not as good as those in the Brazilian bone-bridge group. The American bone-bridge and control groups scored lower in the Social Burden, Ambulation, Frustration, Sounds, Utility, and Well-Being domains of the PEQ. Conclusions: While many experts in the care of amputees believe that the distal tibiofibular bone-bridge technique improves patient functional outcomes, our small group of patients treated with this procedure did not appear to have better outcomes than a group of patients treated successfully with a standard surgical technique. More information is needed before the bone-bridge technique can be recommended as an important component of standard transtibial amputation surgery. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
36346497

 

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