Case study: Correction of angular deformity post-trans-tibial amputation to improve prosthesis fit and comfort. (April 2015)

• Record Type: Journal Article
• Authors: Lineham, Beth; Harwood, Paul; Giannoudis, Peter
• Is Part Of: Prosthetics and orthotics international. Volume 39:Number 2(2015:Apr.)
• Page Start: 157
• Page End: 160
• Publication Date: 2015-04
• Subjects: Amputation -- revision -- trans-tibial -- prosthesis fitting; Orthopedic apparatus -- Periodicals; Prosthesis -- Periodicals; Implants, Artificial -- Periodicals; 617.905
• DOI: 10.1177/0309364613516485
• Languages: English
• ISSNs: 0309-3646

Abstract

Background: This case report describes the revision of a trans-tibial amputation complicated by a proximal malunited fracture. It demonstrates the complexity of decisions involved in revisions of this nature. Case description and methods: The patient presented has a painful stump due to breakdown of soft tissues. She had been suffering for over a year with pressure sores and inability to use a prosthesis resulting from this, decreasing her quality of life. Malunion of a tibial fracture proximal to the amputation complicated her condition. Findings and outcomes: Initially it was feared that the amputation level would be converted to a through-knee amputation, but wedge osteotomy of the tibia allowed coverage of the stump, increasing functionality for the patient, while still maintaining a below-knee stump. Conclusion: This report highlights the importance of addressing the cause of soft tissue problems in an amputation revision, which must be addressed on a case-by-case basis. Clinical relevance: This case offers an insight into the decision-making process in limb reconstruction and suggests a solution for similar cases. It is important that all surgical options are considered before amputation length is sacrificed.