Revisiting transtibial amputation with the long posterior flap

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Amputation Techniques

Background:

• The long posterior flap has been a standard for transtibial amputations.
• Recent challenges to its theoretical basis prompted this assessment.
• Evaluating the efficacy of the long posterior flap in leg amputations.

Purpose of the Study:

• To assess the outcomes of the long posterior flap technique for transtibial amputation.
• To compare the long posterior flap with alternative methods.
• To validate the continued use of the long posterior flap.

Main Methods:

• Prospective cohort study conducted from 1987 to 1996.
• Data collected contemporaneously on diagnosis, procedure, and outcomes.
• Inclusion of patients referred for leg amputation at Dundee Limb Fitting Centre.

Main Results:

• 395 patients underwent transtibial amputation using the long posterior flap.
• Primary healing achieved in 317 patients; 11 healed by secondary intention.
• 51 patients required local wedge resection; 16 had secondary transfemoral amputation.

Conclusions:

• The long posterior flap technique yielded favorable results compared to published series.
• The long posterior flap is recommended as the preferred method for routine transtibial amputation.
• No superior technique has emerged to replace the long posterior flap for standard transtibial amputations.