Tibiofibular Bridge Synostosis in Below-Knee Amputation

Amputation surgery should be viewed by patient and surgeon as the next step toward reconstructive recovery. Surgically removing diseased and nonfunctional distal extremity tissues and fashioning a competent and painless residual limb for ambulation is the ultimate goal. The below-knee amputation level continues to provide adequate outcome for a wide range of morbidities. The development of the tibiofibular synostosis technique in below-knee amputation, as first described by von Ertl in 1949, offers theoretical benefits for prosthetic end bearing for high-demand patients. This article presents a guide for consideration, planning, and performance of a technique for tibiofibular synostosis.