Fibula graft under compression for the optimization of the transtibial amputation stump.

Silva, Erica Blenda da; Andrade, Andre Luis Lugnani de; Rossi, Felipe Lins; Belangero, William Dias; Livani, Bruno · Injury · 2025

case_series · Level IV

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Abstract

This study evaluates the effects of a modified bone bridge technique using a fibular graft with interfragmentary compression in transtibial amputation stumps, with the goal of reducing tibia-fibula mobility and enhancing terminal weight-bearing capacity and rehabilitation. Eleven patients, eight males and three females, underwent transtibial amputation using this technique. All grafts weresuccessfully integrated, with fragment union achieved within three months. No major stump complications were observed, although three patients required screw removal due to washer-related pain. Functionally, all patients underwent axial loading assessed by an examiner, with stump load tolerance being evaluated using a conventional scale. All patients tolerated axial loading without pain or discomfort, with an average maximum load-bearing capacity of approximately 50 % of body weight. This technique effectively creates a rigid bone bridge suitable for shorter residual limbs, facilitating prosthetic fitting and rehabilitation.

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