The ideal length of the residual limb (stump) for a trans-tibial (below-knee) amputation to achieve optimal prosthetic fit and function is:

• A 5 cm below the tibial tuberosity
• B The longest possible length at the ankle level
• C 12–15 cm below the tibial tuberosity (mid-tibial length) ✓
• D 5 cm above the ankle mortise

Explanation

For below-knee (trans-tibial) amputation, the optimal stump length is 12–15 cm below the tibial tuberosity (approximately mid-tibial level). This provides adequate lever arm for prosthetic control and sufficient soft tissue for stump coverage. Stumps shorter than 5 cm from the tibial tuberosity may not provide enough lever arm and prosthetic fitting is difficult. Very long stumps near the ankle have thin soft tissue coverage and poorer vascular supply, making healing problematic. The skin is closed with myoplasty to cushion the bony stump.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.