Distal Tibiofibular Bone Bridge in Transtibial Amputation

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Ertl bone bridging at the time of primary or revision transtibial (below knee) amputation is currently the most controversial issue facing surgeons involved in the care of young, active amputees. Although Ertl suggested that bone bridging allows end bearing weight bearing, many experts now suggest that the bone bridge has the capacity to enhance prosthetic limb fitting by creating a larger, more stable bony platform for load transfer during weight bearing with a prosthetic limb. This discussion highlights the potential benefits afforded by a bone bridge and the role of an enhanced soft tissue envelope in decreasing pain for active lower extremity amputees.

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