Hello llangecpo,
I have compiled articles for you, in no particular order. All the
articles can be copied and pasted into a word processing document for
saving, and some have a Print format as well. The Adobe .pdf
documents can be downloaded easily by clicking the floppy disk icon,
or going to Fileà Save a Copy.
Considering there were 271,550 dysvascular transtibial amputations
from 1988-1996, 14,244 trauma related, and 1,501due to cancer, there
is a dearth of articles on the topic. I performed an extensive and
exhaustive search, to come up with all I have collected.
http://www.medscape.com/viewarticle/444327_4
Click on Table 2 (you will need a free Medscape subscription to see this article)
?The transtibial amputation is one of the most frequently performed
major limb amputations in the United States?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10212603
===============
Ertl Procedure:
===============
1)"The Ertl transfemoral operation is very similar to the more
familiar transtibial procedure with the exception that the presence of
only one bone precludes creating a bone bridge. Instead, the
periosteum is used to close the femoral medulary canal in such a way
that the end of the shaft is somewhat flared in appearance, in an
effort to increase the surface area potentially available for bony end
bearing. Once healing is complete, the end of the femur has a contour
much like an endoskeletal adapter for a solid-ankle prosthetic foot."
http://www.oandp.com/news/jmcorner/2003-11/1.asp
2) http://www.oandp.com/news/jmcorner/2003-12/3.asp
3) Ertl Procedure
http://www.ertlreconstruction.com/Medical%20information.htm
4) http://www.ampu-cycle.com/Ertl%20News%20and%20Views.htm
5) http://www.lists.ufl.edu/cgi-bin/wa?A2=ind9803&L=oandp-l&F=&S=&P=3390
6) http://www.biomech.com/db_area/archives/2002/0211.O&P3.bio.shtml
7) http://www.ertlreconstruction.com/Scott.htm
8)You can see an x-ray of a bony bridge:
http://www.oandp.com/news/jmcorner/2003-10/1.asp
9)The use of bone bridges in transtibial amputations.
Okamoto AM, Guarniero R, Coelho RF, Coelho FF, Pedrinelli A.
http://www.ampu-cycle.com/Ertl%20News%20and%20Views.htm
10)THE USE OF BONE BRIDGES IN TRANSTIBIAL AMPUTATIONS (Same name as
the article above, but different articles.)
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812000000400003&tlng=es&lng=en&nrm=iso
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812000000400003&lng=en&nrm=iso
11)Lower Extremity Reconstruction, Tibia
"In the last 20 years, the advent of microsurgery and its application
to bone transfers has radically changed the treatment of complex
tibial injuries, allowing plastic surgeons to reconstruct wide bone
gaps with optimal functional, morphological, and cosmetic outcome?in
most instances avoiding the need for limb amputation or shortening.
Free vascularized fibular transfer has become the standard practice to
bridge long (>6 cm) bone defects of the extremities."
http://www.emedicine.com/plastic/topic199.htm
12)Osteomyoplasty for Transtibial Amputation: A Case Report and Review
of the Literature
Subscription Only
http://www.oandp.org/Account/Login.asp?frmDestination=%2Fjpo%2Flibrary%2F2004%5F01%5F002%2Easp%3F&frmReason=MEMBERSONLY
Cached page of above:
http://216.239.57.104/search?q=cache:cJIg7pnKCXAJ:www.oandp.org/jpo/library/2004_01_002.asp+transtibial+amputation+%2B+bone+bridge&hl=en
13)"We performed a revision amputation with the bridge technique (a
screw with bone graft is placed between the tibia and fibula) to
provide more stability to the residuum and to correct the prominent
bone that was causing her ulcerations. This is a new technique for
amputations that will have a profound impact on the functional level
and quality of life of individuals who have lost their lower
extremities from injury, disease, etc. The screw and bone graft that
is inserted between the two bones that form the base of the residuum
serves to provide increased stability and therefore less pain for
weight-bearing activities."
http://www.aaos.org/wordhtml/Wash/RHD_PtSuccess.htm
14)Limb reconstruction (You'll need a free registration)
www.medscape.com/viewarticle/418939?src=search
15)Outcome Following Transtibial Amputation Modified With a Distal
Tibio-Fibular Synostosis - David O. Navid, D.O.; Lew C. Schon, M.D.;
Chris Stroud, M.D.; John Logue; Kelly Short (Baltimore, MD)
http://www.aofas.org/displayindustryarticle.cfm?articlenbr=13406
16)Fracture Principles
http://som.flinders.edu.au/FUSA/ORTHOWEB/notebook/trauma/fractures.html
17)Tibia Reconstruction
http://www.emedicine.com/plastic/byname/lower-extremity-reconstruction-tibia.htm
Paid Subscription Only
18)www.oandp.org/jpo/library/2004_01_002.asp - 21k
http://www.oandp.org/Account/Login.asp?frmDestination=%2Fjpo%2Flibrary%2F2004%5F01%5F002%2Easp%3F&frmReason=MEMBERSONLY
A cached version is available here, without need of subscription.
www.oandp.org/jpo/library/2004_01_002.asp - 21k
Of possible Interest:
19)FRACTURE OF THE PROXIMAL TIBIAL EPIPHYSIS, MILAN S. MOORE, MD,
Resident Orthopaedic Surgery - WILLIAM G. MACKENZIE, MD, Pediatric
Orthopaedic Surgery Attending, April 4, 1996
http://gait.aidi.udel.edu/res695/homepage/pd_ortho/educate/clincase/tepip.htm
20)Abstract only, full text requires paid subscription
http://www.ertlreconstruction.com/Medical%20information.htm
21)"In Rich?s words, ?The process involves building a bridge of bone
from the tibia to the fibula along with a myodesis of the muscle
tissue to the distal tibia (that is, the opposing bundles of cut
muscle tissue are sewn to small holes drilled into the end of the bone
of the residual limb).?The major significance of this procedure is the
increased surface area available for loading. Because the muscle has
been directly attached to the bone, it remains active ? thus
maintaining its mass or even increasing in size."
http://www.vvdailypress.com/health/fitness/running/
22)Ertl surgeons
http://www.ertlreconstruction.com/Ertl%20Reconstruction%20Surgeons.htm
23)Follow Up on Transtibial Amputees from the Vietnam War
http://www.ejbjs.org/cgi/eletters/83/3/383
24)Strengthining Ties That Bind
http://www.psia.org/psia_2002/education/TPSArticles/adaptive/tpsspring98advances.asp
25)Interface pressures during ambulation using suction and
vacuum-assisted prosthetic sockets
http://www.vard.org/jour/02/39/6/Beil.html
26)Health Related Quality of Life in Patients with Transtibial
Amputation and Reconstruction with Bone Bridging of the Distal Tibia
and Fibula
http://www.aaos.org/wordhtml/anmt2004/sciprog/070.htm
27)Anticipating amputation: The case for communication
Forward-thinking surgeons are seeking input from prosthetists and
other practitioners in developing techniques that will improve
functional outcomes in amputees.
http://www.biomech.com/db_area/archives/2003/0302.cover.bio.shtml
29)MODIFIED ERTL PROCEDURE FOR TERMINAL OVERGROWTH IN CHILDHOOD BELOW-KNEE LIMB
DEFICIENCIES: COMPARISON WITH EXCISION AND PERIOSTEAL CLOSURE
http://www.cpowestmichigan.com/documents/ertlpapernash.html
30) http://www.owwco.com/HTMLViewer.asp?PK=amp_larry_corley.htm
31)"I was then revised to 18cm with again, poor results, this
time due to poor management of both soft and hard tissues. Another
revision brought me to about 17cm, this time by Ernest Burgess of the
Seattle area. His was a good job for sure, but I wish I had had an Ertle
procedure wherein the bone bridge was formed between tibia and fibula.
Alas, water under the bridge. I still cannot end bear much, but at least
I wasn't hacked."
http://www.lists.ufl.edu/cgi-bin/wa?A2=ind9901&L=oandp-l&F=&S=&P=9427
HTML format
http://216.239.57.104/search?q=cache:gK3t9FhOJDMJ:members.iinet.net.au/~tong/selfassess/muscskel/lowerlimbq.doc+below+amputation+bridging+tibia+fibula&hl=en
32)A video on the Ertle procedure
http://www.ampu-cycle.com/barr%20foundation.htm
33)Management of gap non-union of tibia by tibialisation of
ipsilateral vascular fibula
34) http://www.jpgmonline.com/article.asp?issn=0022-3859;year=1996;volume=42;issue=4;spage=109;epage=11;aulast=Date
35) A Combination of the Tibial-Inlay and Two-Femoral-Tunnel Techniques
http://journal.ajsm.org/cgi/content/full/31/2/196
36)Tibia Fractures
http://www.medscape.com/viewarticle/420563?src=search
37)Fracture healing using Bony Bridges
http://www.engin.umich.edu/class/bme456/bonefracture/bonefracture.htm
I hope this helps you! If these articles are not what you are seeking,
or if I have duplicated articles you already had, please request an
Answer Clarification, before rating. This will enable me to assist you
further, if possible.
Regards,
crabcakes
Search Terms
Ertl procedure
transtibial pinning
transtibial bridge
transtibial bony bridge
tibia fibula bone bridge
pinning tib-fib post amputation
pinning tibia fibula post amputation
bridging tibia fibula
osteomyoplastic lower extremity amputation reconstruction
btk amputation bridge |
Clarification of Answer by
crabcakes-ga
on
28 Oct 2004 09:22 PDT
Hi llanllangecpo,
Thank you for clarifying, before rating! It must be frustrating to
you, as it was to me, not to encounter significant articles on the
topic of transtibial amputation, transtibial fibula bridging, etc.
In your original quesion, you asked for "articles", and did not
specify medical journal articles. While I most certainly tried to find
articles of this kind, as they are definitly preferred to laymen's
articles, this is all I have found.
Many of the article's particularly the Medscape and PubMed articles
are abstracted from medical journals. Most, perhaps all, medical
journals are listed in Medline/Medscape/PubMed, whose databases I
scoured.I spent hours searching, actually, as I expected to find more
on this topic. Most medical journal sites themselves, or to read
entire articles are by paid subscription. For example:
The American Journal of Orthopedics
http://www.amjorthopedics.com/html/sub/sub.asp
"Articles in The American Journal of Orthopedics are indexed in Index
Medicus/PubMed, which can be searched for the abstracts of articles
published in the journal."
http://www.amjorthopedics.com/html/abs/abs.asp
Here is a link to the Medicus/PubMed search I performed using "tibia
fibula bridge", which netted the following results.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
It did link to one article, which again, is the Ertl procedure
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7029943
"tibia fibula pinning" Of the three pages, none were focused on
transtibial bridging/pinning post BTK amputation.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
Using the term "transtibial amputation" None of the 7 pages of
results yields any articles related to bone bridge or pinning.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
My search on Current Opinion of Orthopaedics yielded:
http://www.co-orthopaedics.com/pt/re/coortho/searchresults.htm;jsessionid=BBWpa5a4aEC9JXHtUaKCAnY1Vrcw1442JYP2pNMYJORVdiotgb2Q!368654479!-949856031!9001!-1?&index=1&results=1&searchid=1
Using "tibia fibula pinning" "tibis fibula bridge" yielded
http://www.co-orthopaedics.com/pt/re/coortho/searchresults.htm;jsessionid=BBWpa5a4aEC9JXHtUaKCAnY1Vrcw1442JYP2pNMYJORVdiotgb2Q!368654479!-949856031!9001!-1?&index=1&results=1&searchid=3
My search of The Journal of Bone and Joint Surgery returned nothing.
http://www.jbjs.org.uk/
To read complete articles, one must have a paid subscription, which is
reduced for students:
http://www.jbjs.org.uk/subs_jbjs.htm
Journal of Orthopaedic Surgery search yielded only this
Perioperative and rehabilitation outcome after lower-limb amputation
in elderly Chinese patients in Hong Kong
http://www.josonline.org/index.html
http://www.josonline.org/index.html
A search of the Journal of the Academy of Orthopaedic Surgeons itself
is not searchable, without a paid subscription. However I did include
an abstract or two from this journal in my answer, which does pertain
to tibial-fibula bridging:
http://www.aaos.org/wordhtml/Wash/RHD_PtSuccess.htm
http://www5.aaos.org/jaaos/index.cfm
Subscription Information
http://www5.aaos.org/jaaos/subscriber.cfm
I did not include all my "empty" searches in my answer, as perhaps I
should have. I am including some of them now so you can see that there
truly are few articles in respected medical journals. I have not
included ALL of my null searches, but they were considerable.
If you have access to a medical school or hospital medical library,
you may be given access to some of these journals from within the
library itself, either free, or for a limited time.
If you are still displeased with the results of my extensive searches,
please advise me, I will ask the editors to remove my answer.
Sincerely,
crabcakes
|
Clarification of Answer by
crabcakes-ga
on
03 Nov 2004 12:14 PST
Hi again llangecpo,
I ran into an orthopedic surgeon I once worked with today, and of
course, I asked him where I could find articles that you were seeking.
He confirmed the numbers of BTK amputations, and was amazed at what I
was able to find.
He told me pinning is almost never done, and never in the US. the
reason being it serves no purpose. He said the tibia is filed down
short, and beveled, and the fibula is not needed at all, and can be
cut off short. Some surgeons bring the gastrocnemius muscle up and
wrap it around the tibia. Even for a prosthesis, he said, there is no
need for a tib-fib pinning. Neither the tibia nor fibula is used for
support. The prosthesis is attached by suction and straps, and has no
use for the stumps of a tibia and fibula.
Hope this additional information is useful
Regards,
crabcakes
|
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