Stump refashioning technique in lower limb osseointegration

TL;DR

This study examines surgical techniques for managing complications in osseointegration procedures for lower limb amputees.

Contribution

The study introduces a stump refashioning technique to improve outcomes in osseointegration surgeries.

Findings

32.9% of transfemoral cases required stump refashioning surgery.

20.9% of transtibial cases involved stump refashioning.

Careful soft tissue management reduces stoma pain and infections.

Abstract

Osseointegration represents an innovative technique within the field of limb amputation. The management of a permanent stoma through the residuum presents significant challenges, primarily due to the insufficient literature and limited surgical techniques available. This study aims to unravel soft tissue management strategies that seek to enhance surgical outcomes.

It is a retrospective study containing a total of 406 patients (251transfemoral and 155 transtibial) amputees who underwent (264 trans-femoral and 177 transtibial) osseointegration at Macquarie University Hospital and Norwest Private Hospital were systematically evaluated over the period spanning from December 2010 to December 2023. Out of a total of 264 transfemoral cases, 87(32.9%) cases necessitated stump refashioning surgery. In transtibial osseointegration, 37/177 cases (20.9%) of stump refashioning events were observed among the cohort.

This study describes the surgical technique and the importance of careful soft tissue management in stump refashioning. It addresses issues of stoma pain, overhanging soft tissue, and infections to prevent potential complications and improve quality of life.

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