A 30-year-old man undergoes a transtibial (below-knee) amputation following a traumatic injury. Regarding the ideal stump for prosthetic fitting, which statement is CORRECT?

• A The stump should be as long as possible; the more length retained the better, regardless of soft tissue coverage
• B The fibula should be left at the same length as the tibia for equal weight-bearing
• C The posterior flap should be equal in length to the anterior flap for a symmetric closure
• D The ideal transtibial stump length is 12-15 cm from the tibial tubercle, with a myoplastic closure (muscle capping the bone end) and appropriate skin coverage ✓

Explanation

The ideal transtibial stump is 12-15 cm from the tibial tubercle (or 2/3 of tibial length) — long enough for effective prosthetic lever arm but short enough to prevent skin coverage problems. Myoplasty (suturing the anterior and posterior muscle groups over the bone end) provides padding, proprioceptive input, and prevents bone erosion through skin. The fibula is beveled 1-2 cm shorter than the tibia and rounded to prevent a pointed end. The posterior flap technique uses the longer, better-vascularised posterior flap to cover the bone end — it is the preferred closure technique, making the posterior flap longer than the anterior flap.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.