This is, perhaps the most significant level of amputations, as it is addressed to the majority of the patients.
In terms of technical features, we want the distal end of the tibial abutment to be 12-15 cm, while the ends of both the tibia and fibula bone should be shaped properly and adequately covered with soft tissue.
This biomechanical condition provides us with the required elevation for the placement of the prosthetic ankle and simultaneously offers to the patient an adequate tibial arm for the effective control of the prosthesis.
In order to design the socket of the tibial abutment, we utilize the principle of the patellar ligament charge, while transferring partially the load on the areas on either side of the tibia and across the surface of the gastrocnemius abutment. By using this specific technique, the load is distributed correctly (total contact), while protecting the sensitive areas of the popliteal field and the front edge of the tibia.
In order to place the socket on the abutment, we mainly utilize the silicone or polyurethane socks. Due to their increased endurance and the comfort they provide for the patient, they are very user friendly and have been utilized with great success. They are available on the market in various types, both in the basic and the conical shape, with a pin, ring or other variations. The selection is made by the prosthetic, based on the morphology of the abutment, the existing muscular status, as well as the activity levels of the patient.
The positive benefits are:
- High durability
- Security and stability of the harder outer layer, comfort and shock absorption by the softer inner layer.
- Beneficial ingredients are included to prevent and protect the skin, leaving a pleasant fragrance.
- Easy to insert and remove the prosthesis.
As we have mentioned in femoral amputations, the construction of the tibial socket and the choice of silicone constitute the most important parameters for the success of rehabilitation.
Finally, the prosthesis is completed with its outer covering for aesthetic reasons. We use foam coating or silicone padding, in full harmony with the colors and the characteristics of the healthy limb.