Outcomes after 294 transtibial amputations with the posterior myocutaneous flap

The transtibial amputation is a common operation for which there is little agreement regarding which technique provides the most reliable and resilient outcomes. We performed a retrospective chart review of all transtibial amputations performed by a single surgeon between 2004 and 2011 using the posterior myocutaneous flap with triceps surae myodesis technique. A stepwise logistic regression analysis was performed to evaluate the association between independent variables and dependent outcome variables. A total of 270 patients with 294 transtibial amputations were identified. Ambulation data were available for 192 patients with a mean follow-up 18.4 months. This cohort had an overall ambulation rate of 75%, a 12% incidence of stump wounds, 24% operative revision rate and only 2% required conversion to a transfemoral amputation. The posterior myocutaneous flap provides durable and reliable soft tissue coverage in the setting of a transtibial amputation.