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Published on: January 24, 2018
Case study: Correction of angular deformity post-trans-tibial amputation to improve prosthesis fit and comfort
Beth Lineham1, Paul Harwood2, Peter Giannoudis2
1Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, Leeds, UK bethbrown@doctors.org.uk.
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.
