Comparison of Functional Outcomes Following Bridge Synostosis with Non-Bone-Bridging Transtibial Combat-Related Amputations

Abstract

Background: The prevalence of penetrating wartime trauma to the extremities has increased in recent military conflicts. Substantial controversy remains in the orthopaedic and prosthetic literature regarding which surgical technique should be performed to obtain the most functional transtibial amputation. We compared self-reported functional outcomes associated with two surgical techniques for transtibial amputation: bridge synostosis (modified Ertl) and non-bone-bridging (modified Burgess). Methods: A review of the prospective military amputee database was performed to identify patients who had undergone transtibial amputation between June 2003 and December 2010 at three military institutions receiving the majority of casualties from the most recent military conflicts; two of those institutions, Walter Reed Army Medical Center and National Naval Medical Center, have since been consolidated. Short Form-36, Prosthesis Evaluation Questionnaire, and functional data questions were completed by twenty-seven modified Ertl and thirty-eight modified Burgess isolated transtibial amputees. Results: The average duration of follow-up after amputation (and standard deviation) was 32 22.7 months, which was similar between groups. Residual limb length was significantly longer in the modified Ertl cohort by 2.5 cm (p < 0.005), and significantly more modified Ertl patients had delayed amputations (p < 0.005). There were no significant differences between groups with regard to any of the Short Form-36 domains or Prosthesis Evaluation Questionnaire subsections. Conclusions: The modified Ertl and Burgess techniques offer similar functional outcomes in the young, active-duty military population managed with transtibial amputation.

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Document Details

Document Type
Technical Report
Publication Date
May 15, 2013
Accession Number
ADA614700

Entities

People

  • Benjamin K. Potter
  • David E. Gwinn
  • John J. Keeling
  • Jonathan A. Forsberg
  • Joseph R. Hsu
  • Kevin L. Kirk
  • Scott B. Shawen

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Amputation
  • Amputees
  • Databases
  • Information Science
  • Lower Limb Amputations
  • Lower Limb Amputees
  • Medical Personnel
  • Military Medicine
  • Prostheses And Implants
  • Regression Analysis
  • Residual Limbs
  • Statistical Analysis
  • Surgery
  • Surgical Amputations

Fields of Study

  • Medicine

Readers

  • Ballistic Missile Meteorology
  • Systems Analysis and Design
  • Trauma Surgery or Emergency Medicine.