Outcomes after 294 transtibial amputations with the posterior myocutaneous flap

Int J Low Extrem Wounds. 2014 Mar;13(1):33-40. doi: 10.1177/1534734614520706. Epub 2014 Feb 6.


The transtibial amputation is a common operation for which there is little agreement regarding which technique provides the most reliable and resilient outcomes. We performed a retrospective chart review of all transtibial amputations performed by a single surgeon between 2004 and 2011 using the posterior myocutaneous flap with triceps surae myodesis technique. A stepwise logistic regression analysis was performed to evaluate the association between independent variables and dependent outcome variables. A total of 270 patients with 294 transtibial amputations were identified. Ambulation data were available for 192 patients with a mean follow-up 18.4 months. This cohort had an overall ambulation rate of 75%, a 12% incidence of stump wounds, 24% operative revision rate and only 2% required conversion to a transfemoral amputation. The posterior myocutaneous flap provides durable and reliable soft tissue coverage in the setting of a transtibial amputation.

Keywords: below-knee amputation; lower extremity salvage; prosthetic limb; transtibial amputation.

MeSH terms

  • Amputation / methods*
  • Amputation / rehabilitation
  • Artificial Limbs
  • Diabetic Foot / rehabilitation
  • Diabetic Foot / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Leg
  • Male
  • Middle Aged
  • Myocutaneous Flap*
  • Retrospective Studies
  • Tibia / surgery*
  • Time Factors
  • Treatment Outcome
  • Walking / physiology