%0 Journal Article
%T Cortical tibial osteoperiosteal flap technique to achieve bony bridge in transtibial amputation: experience in nine adult patients
%A Mauricio Leal Mongon
%A Felipe Alberto Piva
%A Sylvio Mistro Neto
%A Jose Andre Carvalho
%A William Dias Belangero
%A Bruno Livani
%J Strategies in Trauma and Limb Reconstruction
%@ 1828-8928
%D 2013
%I Springer
%R 10.1007/s11751-013-0152-0
%X Amputation, especially of the lower limbs, is a surgical procedure that gives excellent results when conducted under the appropriate conditions. In 1949 Ertl developed a technique for transtibial osteomyoplastic amputation which restored the intraosseous pressure through canal obliteration and expanded the area of terminal support through a bony bridge between the fibula and distal tibia. The aim of this study was to investigate the effectiveness of a modification of the original ErtlĄ¯s technique in which a cortical osteoperiosteal flap created from the tibia is used to form a bony bridge during transtibial amputation in adults. Nine patients underwent leg amputations with the cortical tibial osteoperiosteal flap technique for reconstruction of the stump. The average duration of follow-up was 30.8 (range, 18¨C41) months. The post-surgery examination included a clinical examination and radiography. A 6-min walk test (Enright in Respir Care 48(8):783¨C785, 2003) was performed in the 32nd week after amputation. At 24th week post-surgery, all patients had stumps that were painless and able to bear full weight through the end. The creation of a cortical osteoperiosteal flap from the tibia to the fibula during transtibial amputation is a safe and effective technique that provides a strong and painless terminal weight-bearing stump. This constitutes a useful option for young patients, athletes, and patients with high physical demands.
%K Amputation
%K Surgical technique
%K Tibia
%K Fibula
%K Flap
%U http://link.springer.com/article/10.1007/s11751-013-0152-0