Evolution and Modification of the Ertl Osteomyoplastic Transtibial Amputation

The goal of amputation surgery in the lower extremity is to allow patients to return to a functional and active lifestyle. Osteomyoplastic modification of traditional transtibial amputations can facilitate improved weight-bearing mechanics, thereby minimizing the demands upon the patient and physician. We performed a modified Ertl osteomyoplasty for transtibial amputations in select patients, using the TightRope fixation system (Arthrex, Naples, FL). Based on our experience, this is an effective and simple method to secure the fibular bone bridge, with all but a single patient healing with a solid synostosis of the tibia and fibula. This has allowed hastened rehabilitation and functional use of a prosthetic.