Health-related quality of life in patients with transtibial amputation and reconstruction with bone bridging of the distal tibia and fibula

Michael S. Pinzur*, Marco A Guedes S Pinto, Matthew Saltzman, Fabio Batista, Frank Gottschalk, Dainius Juknelis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Background: Bone-bridging (arthrodesis of the distal tibia and fibula) at the time of transtibial amputation is a controversial operative technique that is anecdotally reported to improve the weightbearing capacity of the residual limb and to decrease residual limb discomfort. Methods: Thirty-two consecutive patients with multiple diagnoses had transtibial amputation with a distal tibial-fibular bone-bridge, all done by a single surgeon (MAP). At an average of 16.3 months after surgery all patients completed the Prosthetics Evaluation Questionnaire (PEQ), a validated outcomes instrument specifically created to evaluate quality of life and functional demands in patients with a lower extremity amputations. Their responses were compared with those of 17 preselected, highly functional transtibial amputees from two academic medical centers who previously had transtibial amputations using a traditional non bone-bridge operative technique; their time since amputation averaged 14.7 years. Results: The "nonselected" consecutive patients with a bone-bridged residual limb scored higher (more favorable) in the Ambulation (p = 0.037) and Frustration (p < 0.001) domains of the PEQ and lower (less favorable) in the Appearance (p = 0.025) subscale. Their scores were similar in the other six domains. Conclusions: Patients of multiple ages with multiple diagnoses who had bone-bridging of the distal tibia and fibula at the time of franstibial amputation had scores on a validated outcomes instrument that were better than or comparable to those of a selected group of highly functional transtibial amputees. The results of this study suggest that bone-bridging at the time of transtibial amputation may enhance patient-perceived functional outcomes.

Original languageEnglish (US)
Pages (from-to)907-912
Number of pages6
JournalFoot and Ankle International
Issue number11
StatePublished - Nov 2006


  • Bone Bridge
  • Outcomes
  • Transtibial Amputation

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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