title: [Applications of myo-periosteal fibular bone bridging for traumatic transtibial amputation].
abstract: OBJECTIVE
  To compare the effectiveness between the myo-periosteal fibular bone bridging and traditional transtibial amputation in the treatment of amputation below knee so as to provide theoretical basis for choosing transtibial amputation in clinical application.
  
  
  METHODS
  Between November 2001 and November 2011, 38 patients with mangled lower extremity were treated by transtibial amputation. Among 38 patients, 17 (group A) underwent myo-periosteal fibular bone bridging (the operation techniques of an attached peroneal muscle myo-periosteal fibular strut bridge between the end of the tibia and fibula below knee amputation), and other 21 (group B) underwent traditional transtibial amputation. There was no significant difference in age, gender, injury cause, amputation cause, side, and disease duration between 2 groups (P > 0.05). The quality of life (QOL) was analyzed using 36-item short form health survey (SF-36), and prosthesis satisfaction by Trinity amputation and prosthesis experience scale (TAPES).
  
  
  RESULTS
  Healing of incision by first intention was obtained in all patients of 2 groups; no necrosis, infection, or poor stumps was observed. The mean follow-up time was 22 months (range, 14-30 months) in group A, and 26 months (range, 15-30 months) in group B. The patients achieved good healing of bone bridging, no bone nonunion occurred. The healing time was (5.1 +/- 1.1) months in group A and (3.3 +/- 0.6) months in group B, showing significant difference between 2 groups (t=9.82, P=-0.00). Spur occurred at the distal fibula in an 11-year-old boy of group B after 2 years of operation, which blocked use of prosthesis; prosthesis was well used in the other patients. After 12 months of operation, SF-36 score was 55.84 +/- 14.01 in group A and 49.93 +/- 12.78 in group B, showing significant difference (P < 0. 05); the physical functioning, social functioning, role-physical, vitality, body pain, general health scores in group A were significantly higher than those in group B (P < 0.05), but no significant difference was found in role-emotional and mental health scores between 2 groups (P > 0.05). TAPES score was 12.12 +/- 2.23 in group A and 10.10 +/- 2.00 in group B, showing significant difference (t=2.891, P=0.006).
  
  
  CONCLUSIONS
  It is a very effective method to treat traumatic amputation using an attached myo- periosteal fibular bone bridging between the end of the tibia and fibula below knee, which can afford better quality of life and prosthesis satisfaction.
authors: Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai, 200940, P.R.China.
authors: Dengxin
authors: D
authors: Song
authors: Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai, 200940, P.R.China.
authors: Qianfa
authors: Q
authors: Zhang
authors: Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai, 200940, P.R.China.
authors: Cheng
authors: C
authors: Zhu
authors: Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai, 200940, P.R.China.
authors: Xiaowen
authors: X
authors: He
authors: Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai, 200940, P.R.China.
authors: Xiaohui
authors: X
authors: Liao
authors: Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
authors: Chengla
authors: C
authors: Yi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000009:adverse effects / Q000379:methods*; D000673:Amputation, Traumatic / Q000150:complications / Q000601:surgery*; D001186:Artificial Limbs; D002648:Child; D005260:Female; D005360:Fibula / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007869:Leg Injuries / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D012086:Reoperation; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult