Article

Lower limb amputations should be evaluated carefully, especially with
regard to the possibility of preserving the knee joint to enable a more
physiological gait and lower energy consumption. Below-knee amputations were
performed immediately below the tibial tuberosity with maintenance of the
insertion of the patellar tendon, resulting in very short, but functional stumps.
This case study examined whether very short below-knee stumps allow a more
functional gait, as compared to more proximal amputations. Case Description and
Methods: Between June 2010 and June 2011, four patients had extremely short
below-knee amputations, with resection of the head of the fibula at the junction
and reinsertion of the collateral ligaments and structures attached to the tibia.
This was followed by placement of a prosthesis with a vacuum-assisted suspension
socket. Findings and Outcome: At the end of treatment, patients that underwent
transtibial amputations with an extremely short stump were considered well
adapted to their prosthesis and were satisfied in relation to the acquired gait
patterns. Conclusion: The extremely short below-knee amputation, despite having a
short lever arm should be considered as another option for lower-limb
amputations, although we cannot yet assure that other patient groups undergoing
this level of amputation may have the same results of the study. Clinical
relevance The extremely short below-knee amputation, despite having a short lever
arm should be considered as an option for lower limb amputations, as it can
provide a prosthetic provision with a good functional outcome.

Langue : ANGLAIS