Alternative Bone Graft Sources and Techniques for Tibiofibular Synostosis Creation Following Transtibial

Amputation

by Archie Overmann, and Benjamin K. Potter

JBJS Case ConnectVolume 5(1):e18

February 25, 2015

©2015 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior injury radiograph demonstrating a traumatic right transtibial amputation with evidence of fibular interosseous membrane disruption and potential fibular instability, as well as

traumatized local soft tissue requiring additional shortening of...

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Follow-up radiograph upon presentation to our clinic with symptomatic residual fibular instability (Case 1).

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Preoperative osseous status.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

The postgraft state after the harvest of an approximately 3-cm length of lateral tibial cortex, 90° lateral rotation, and fixation with the compressive suture bridge construct (Case 1).

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Preoperative anteroposterior radiograph of the trauma-related right transtibial amputation demonstrating a long residual tibia with poor distal soft-tissue coverage.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Intraoperative photograph during revision transtibial amputation demonstrating the contoured cylindrical distal tibial graft manually compressed between the fibula and the tibia.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.

Six-month follow-up anteroposterior radiograph of the right transtibial amputation demonstrating stable healing of the cylindrical graft without evidence of migration or complication.

Archie Overmann, and Benjamin K. Potter JBJS Case Connect 2015;5:e18

©2015 by The Journal of Bone and Joint Surgery, Inc.