Improving function in transtibial amputation: the distal tibiofibular bone-bridge with Arthrex Tightrope fixation

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Prosthetics and Orthotics

Background:

• Transtibial amputation presents challenges in residual limb function and patient comfort.
• Traditional methods for distal tibiofibular syndesmosis in amputation have limitations.
• Instability and pain can arise from tibiofibular diastasis after amputation.

Purpose of the Study:

• To describe a new technique for securing the fibular bone block in transtibial amputations.
• To evaluate the efficacy of suture-button fixation for distal tibiofibular bone bridging.
• To improve axial loading, proprioception, and reduce pain in transtibial amputees.

Main Methods:

• A modified fibular bone block technique for distal tibiofibular syndesmosis.
• Utilizing the Tightrope suture-button fixation system (Arthrex) for bone block securement.
• Surgical procedure focused on creating a stable yet dynamic tibiofibular connection.

Main Results:

• The Tightrope system effectively secures the fibular bone block, minimizing symptomatic hardware.
• The technique prevents tibiofibular diastasis while allowing for physiologic micromotion.
• Successful outcomes reported in clinical experience with this new fixation method.

Conclusions:

• The described technique using suture-button fixation offers a successful approach for distal tibiofibular bone bridging in transtibial amputations.
• This method enhances functional outcomes and patient comfort by addressing tibiofibular instability.
• The procedure shows promise for improving prosthetic integration and residual limb proprioception.