An Antibiotic Spacer May Be Used to Acquire Adequate Tibia Length for a Transtibial Amputation to Prevent the Need for a Transfemoral Amputation

Case: We present a case of a 30-year-old man who sustained a traumatic transtibial amputation from a motorcycle accident. Owing to significant posterior tibial bone loss, an antibiotic spacer was used to preserve below-knee amputation level and avoid conversion to a transfemoral amputation. At 2.5 years postoperatively, the patient reported excellent function, full weight-bearing capacity, and no pain, with no further interventions pursued. Conclusion: This case highlights the novel use of an antibiotic spacer to lengthen a transtibial stump, demonstrating an effective salvage strategy that optimizes functional outcomes while avoiding the morbidity associated with higher-level amputation.