Modified tibiofibular synostosis vs. Burgess stump in a bilateral amputee: a case report.
Marc Ruewe, Katharina Rosengarth, Alexandra M Anker et al.
✦ AI-curated · Sources linked
Case in brief
A bilateral transtibial amputee had a modified tibiofibular synostosis (TFS) stump on the right and a conventional Burgess-type stump (BTS) on the left. The modified TFS used a myoplastic sling attaching residual tendons distal to the bone bridge rather than traditional myodesis. Assessment included gait, balance, functional testing, and functional MRI with tractography. The TFS side appeared more efficient for ambulation and was preferred during prolonged standing; testing showed unsteadiness on the BTS side. Imaging also showed different patterns of cortical activation and cerebellar fiber reconstruction during movement of the two stumps.
What made this case unusual
The bilateral amputee provided an within-person comparison of two different stump constructions, including a modified TFS with a distal tendon sling, alongside functional and neuroimaging assessments.
Diagnostic / clinical pearl
Stump function may differ across individuals and across functional tasks; gait, balance, and patient preference can reveal distinctions not captured by a single outcome measure.