Abstract
Purpose:
Despite advances in limb reconstruction, there are still a number of young patients who require trans-tibial amputation. Amputation osteoplasty is a technique described by Ertl to enhance rehabilitation after trans-tibial amputation. The purpose of the present study was to evaluate the results of the original Ertl procedure in skeletally immature patients, and to assess whether use of this procedure would result in a diminished incidence of bony overgrowth.
Methods:
Four consecutive patients (five amputations) treated between January 2005 and June 2008 were reviewed. Clinical evaluation consisted of completion of the prosthesis evaluation questionnaire (PEQ) and physical examination. Radiographic analysis was performed to evaluate bone-bridge healing, bone overgrowth and the medial proximal tibial angle (MPTA).
Results:
The best mean PEQ result in the Question section was 91.8 (Range 74–100) for ‘Well being’ and the worst mean score was 66.6 (Range 50–78) for the sub-section ‘Residual limb health’. Examination of the residual limbs revealed no bursae were present and all knees were stable with full range of movement. All bony bridges united at an average age of 1.7 months (Range 1–2). One case required stump revision for bony overgrowth, and one case developed asymptomatic mild genu varum.
Conclusions:
In this series, the original Ertl osteomyoplasty shows good functional and prosthetic use with only one bony overgrowth requiring revision surgery.
