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Residual Muscle Contraction and Residuum Socket Interface Force in Men with Transtibial Osteomyoplastic Amputation

ABSTRACT In the transtibial osteomyoplastic amputation (TOA) technique, the distal ends of the tibia and fibula are surgically joined to form a “bone bridge” to stabilize the bony anatomy of the distal residuum. The distal-most muscles also are secured to reestablish a length-tension relationship. Unlike conventional amputation techniques in which the muscles are not secured and do not retain length-tension relationship, the TOA procedure is anticipated to allow muscles to actively contract and retain normal physiological function. In this case series, outcomes of the TOA procedure were investigated by measuring electromyography signals from the tibialis anterior and gastrocnemius muscles in the residuum and forces at the residuum socket interface (RSI) in unilateral transtibial amputees with TOA during three types of gait activities (self-paced walking, brisk 2-minute walking, and walking over a distance of 25 ft while carrying various loads). Results confirmed the presence of loadings at the distal residuum and the activity in the residuum muscles during these gaits. Furthermore, statistical analysis showed that when the distal RSI force variation was higher, the residual tibialis anterior muscle was more active compared with its activity at lower distal RSI force variation.