New Article on Ertl Variant

The most recent issue of Prosthetics & Orthotics International includes a number of very interesting and clinically relevant articles. One noteworthy example is a report from Brazil on a series of fifteen transtibial amputations, performed from 1997-2003, that used a fibular strut graft to create a bone bridge. Marco Guedes and his colleague described their method, which is based on the Ertl concept but uses a section of fibula that is dovetailed into the tibia. About half of the cases were revision surgeries and about half were primary amputations.

In their experience, the fib strut method resulted in a residuum that could be fitted an average of three months post-operatively, which is similar to their results with an amputation that does not include the bone bridge. One patient required a revision plus bone grafting and another had a wound dehiscence that delayed healing for six months, but all bridges ultimately solidified by approximately one year post-operatively.

They commented favorably on the increased ability for distal end bearing that the bone bridge offered although no formal outcomes measurements were reported. The limitations noted included the need for sufficient circulation to heal this more extensive procedure, the necessity to shorten the residuum in most cases, and a tendency for blister formation in the early post-op period, which they felt was due to the skin flap mobilization that is required.

This is one of the few peer-reviewed articles on the Ertl procedure and related variants. Congratulations are due to the authors for adding to our understanding by reporting their experiences. [Pinto MAGS, Harris WW. Fibular segment bone bridging in trans-tibial amputation. POI 2004; 28(30) 220-224].

Reader Comments: Read all user comments Asociacion de Estudiantes de Ortesis y Protesis. Ciudad de Mexico 14 de Abril, 2005. Estimado John Michael CPO, FAAOP, FISPO: es muy agradable enterarnos que en el Century College de Minnesota se ha formado, desde hace algunos años, la Asociacion de Estudiantes de O & P. Este es un ejem... read more - Alberto E. Castillo Moreno O. P.   4/14/2005 Re: Asociacion de Estudiantes de Ortesis y Protesis. I agree, Sr. Castillo. The Century College OPSA model is a good one to emulate worldwide, which is one reason I was pleased to feature their work in this corner. Best professional regards. --John Michael CPO - John Michael   4/20/2005 Tabal de Medidas Antropometricas. Ciudad de Mexico 1 de Abril, 2005. Estimado John Michael, CPO, FAAOP, FISPO: Un protesistas de Buenos Aires, Argentina, pregunta si existe alguna Tabla de Medidas Antropometricas para determinar la altura real de una persona amputada bilat... read more - Alberto E. Castillo Moreno O. P.   4/1/2005 Re: Tabal de Medidas Antropometricas. Sr. Castillo- Yes, there are several sources for anthropomorphic data that could be used to predict leg length, bone length, or overall height for a person with bilateral lower limb amputations. This information is often summarized in bas... read more - John Michael   4/1/2005 Protesistas en Miami. Ciudad de Mexico 25 de Marzo, 2005. Estimado John Michael CPO, FAAOP, FISPO: Una persona amputada Latinoamericana viajo a la ciudad de Miami para la adaptacion de un nuevo socket transfemoral. ¿Puede usted recomendar algun practicante c... read more - Alberto E. Castillo Moreno O. P.   3/25/2005 Re: Protesistas en Miami. Dear Sr. Castillo- I recommend searching the ABC web site at www.abcop.org to find Certified Prosthetists in a specific US city or region. There are a large number of good practitioners in the Miami area. --John Michael CPO - John Michael   3/25/2005 Love that Jazz... Hi John, noticed Dave had disappeared from "The Mullet Boyz"...from a fellow drummer great to see he's still beating those skins! - Bill Contoyannis   3/8/2005 how do i get where you are? hello, my name is ashlee kingsberry and i am a student at lebanon high school in lebanon oregon. awhile ago i sent in to this sight to get information about college. i never got anything back. If anyone can give me any information on whe... read more - ashlee kingsberry   3/7/2005 Re: how do i get where you are? Hi Ashlee- As I replied in response to your post back in April of last year, you can go to http://www.opcareers.org to learn more about the prerequisites to enter this field. --John Michael CPO - John Michael   3/7/2005 Jazz Tradicional de Nueva Orleans. Ciudad de Mexico 3 de Marzo, 2005. Estimado John Michael, CPO, FAAOP, FISPO: Disfrutamos los fragmentos de las melodias interpretadas por la banda de jazz The Southside Aces. Felicitamos a su hijo David Michael por su participacion dentro... read more - Alberto E. Castillo Moreno O. P.   3/3/2005 Re: Jazz Tradicional de Nueva Orleans. Thanks for your encouraging comments, Sr. Castillo. I hope other readers also find the occasional brief article on multimedia topics of interest. Best professional regards. --John Michael CPO - John Michael   3/4/2005