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Reamputation stumps below knee.

Viktor I Shevchuk1, Yurii O Bezsmertnyi1, Yankai Jiang1

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Reconstructive surgery using non-free skin grafts and muscle-bone fixation significantly improves outcomes for patients with malformed tibial stumps, ensuring 100% prosthesis compatibility. These techniques create functional, painless residual limbs.

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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.