Transtibialne

Transtibialne, in medical terminology, refers to a transtibial or below-knee amputation, an operation in which the tibia and fibula are cut through at a level below the knee joint, preserving the knee and part of the thigh. The term is used across languages with slight variations (for example transtibialní in some Slavic languages). The procedure creates a residual limb that is intended to bear weight and interface with a prosthetic device.

Common indications for a transtibial amputation include peripheral vascular disease and diabetes, traumatic injury, severe infection, and, less frequently, tumors. The decision balances the need to remove diseased or nonviable tissue with the goal of maintaining as much healthy limb length and function as possible. Advances in vascular care and revascularization have influenced timing and level of amputation in some cases.

The residual limb length and shape influence prosthetic fitting and function. Short, standard, and long residual limbs have different biomechanical and soft-tissue considerations. Prosthetic options for transtibial patients include various socket designs, such as patellar-tendon bearing and total-surface-bearing configurations, and both endoskeletal and exoskeletal systems. Suspension methods (suction, gel liners with pin, vacuum, or mechanical suspension) and components like pylons or microprocessor-controlled ankles may affect stability and energy efficiency. Osseointegration, while explored, is less common in transtibial prosthetics.

Rehabilitation focuses on wound healing, edema control, and knee and hip strengthening, followed by gait training, balance work, and prosthetic best-fit optimization. Phantom limb pain and neuromas are potential postoperative issues. Functional outcomes depend on residual limb length, overall health, comorbidities, quality of rehabilitation, and access to well-fitted prosthetic care.