Reamputation stumps below knee

Area of Science:

• Orthopedic Surgery
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Malformed tibial stumps present complex challenges in prosthetic rehabilitation.
• Common issues include extensive scarring, bone deformities, osteomyelitis, and fibular instability.
• Effective stump reconstruction is crucial for optimal prosthesis function and patient mobility.

Purpose of the Study:

• To evaluate rehabilitation outcomes in patients with various malformed tibial stumps.
• To assess the efficacy of reconstructive surgical techniques for tibial stump defects.
• To determine the long-term functional success of modern prosthesis use after surgery.

Main Methods:

• Analysis of 421 patients with diverse tibial stump malformations and diseases.
• Performance of 436 reconstructive surgeries, including non-free skin grafting and muscle-bone fixation.
• Utilized radiological, ultrasonic, tensometrical, and histological assessments during a 6-month to 15-year follow-up.

Main Results:

• Non-free skin grafting with dermal-subcutaneous flaps effectively covered large defects without shortening the bone.
• Improved muscle-bone fixation techniques created elastic stumps, addressing bone filing and improving coverage.
• Original methods for tibial bone block creation resulted in painless, highly functional stumps, achieving 100% long-term prosthesis use.

Conclusions:

• Non-free dermal plasty with cutaneous-subcutaneous flaps is a preferred method for residual limb skin defects.
• Muscle-bone fixation effectively corrects residual limb deformities, creating elastic stumps.
• Synostosis techniques significantly enhance the functional quality of tibial residual limbs.