A 35-year-old man undergoes an above-knee (transfemoral) amputation for a vascular injury. During stump construction, myodesis is preferred over myoplasty because:
- A It attaches residual muscles directly to the bone, maintaining muscle tension and preventing retraction, improving motor control and prosthetic function ✓
- B It shortens the operative time by avoiding muscle suturing
- C It uses only skin closure, avoiding deep tissue trauma
- D It creates a longer stump by advancing the periosteum distally
Correct answer: A. It attaches residual muscles directly to the bone, maintaining muscle tension and preventing retraction, improving motor control and prosthetic function
Explanation
Myodesis involves suturing the residual muscle to the bone (through drill holes in the cortex or periosteum), maintaining the muscle's resting tension and attachment. This preserves the tension-length relationship, prevents muscle retraction and atrophy, and provides better control of the prosthetic limb through active muscle contraction. Myoplasty (suturing opposing muscle groups to each other over the bone end) is less secure and allows more muscle migration. Myodesis is the preferred technique for transfemoral amputations in young active patients.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.