What is a transtibial amputation?
A transtibial amputation is usually understood to be a surgical separation of the leg below the knee joint. The function of the knee joint is normally retained, so that in most cases a fitting with an adapted prosthesis can be carried out. A transtibial amputation becomes necessary either after a serious accident, in which the lower leg was destroyed to such an extent that it cannot be preserved, or in the case of a severe circulatory disorder, which usually occurs in the context of a “smoker’s leg” with severe arterial calcification. If the lower leg is separated from the body not as part of a surgical procedure but as the result of an accident, this is also called a lower leg amputation.
Indication for transtibial amputation
There are two main types of indications for which transtibial amputation may be indicated. On the one hand, it may be necessary to amputate the leg below the knee joint after a serious accident, for example in road traffic, if the injury is so severe that there is no longer any prospect of the leg healing. On the other hand, there are diseases that may make amputation of the lower leg necessary due to insufficient blood supply to the tissue.
In most cases, the indication in such cases is due to calcification of the blood-carrying arteries in the legs, which is also known as peripheral arterial occlusive disease (PAD) or, in common parlance, “shop window disease”. A lower leg amputation is often preceded by a long ordeal and often the toes or parts of the foot have already been amputated. It is also possible that amputation is necessary in the context of a leg ulcer, the so-called open leg, in the event of circulatory disorders, especially in the case of severe infections of these areas.
There are other diseases or circumstances which may also make a lower leg amputation necessary due to an insufficient supply of nutrients and oxygen. These include, for example, chronic and non-healing wounds and inflamed wounds. Often this is also diabetes mellitus (“diabetes”), which leads to destruction of nerves and blood vessels in the foot and leg. The indication for a transtibial amputation is usually only given if there is no prospect of saving the affected body part and less radical measures such as a forefoot amputation are not considered sufficient.
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