transtibialis

Transtibialis is a term derived from Latin, combining trans- “across” and tibialis “of the tibia.” In medical usage, it most often refers to a transtibial amputation, commonly called a below-knee amputation (BKA), in which the limb is removed through the tibia and fibula below the knee joint while the knee is preserved. The adjective transtibial is widely used in anatomical descriptions to indicate structures or procedures occurring across or at the level of the tibia.

Indications for a transtibial amputation include severe trauma to the lower leg with irreparable soft-tissue or bony injury, extensive infection or gangrene, malignant tumors of the leg, nonunion fractures with chronic pain, and certain vascular or neuropathic conditions where limb salvage is not feasible or would compromise function. Compared with a transfemoral (above-knee) amputation, the transtibial approach preserves the knee joint, which generally facilitates easier prosthetic fitting, gait, and rehabilitation, though the choice depends on tissue viability and overall patient status.

Surgical goals focus on removing diseased tissue while preserving as much healthy tissue as possible and shaping a well-padded, stable residual limb. Techniques may include various soft-tissue resections and muscle stabilization options, such as myodesis (tusing muscle to bone) or myoplasty (muscle to muscle), to improve prosthetic control and reduce pain. The stump is covered with robust soft tissue and skin flaps to withstand prosthetic use.

Postoperative care emphasizes wound healing, edema control, and prevention of knee flexion contractures. Rehabilitation includes physical therapy, desensitization, and gradual progression to prosthetic fitting and gait training. Potential complications include wound infection, delayed healing, neuromas, phantom limb pain, edema, and contractures, but many patients achieve functional mobility with a properly fitted prosthesis.