Prosthetists' Perspective on Surgical Intervention, Postoperative Treatment, and Prosthetic Assessment Following Transtibial Amputation

Background: Many healthcare professionals collaborate in the clinical care of individuals who have undergone a Transtibial Amputation (TTA), and a good start to their rehabilitation is essential.The Prosthetist plays a long-term role in patient care, while surgeons often have limited follow-up, typically 1-2 weeks post-surgery.Objective: This paper aims to present the perspective of two Prosthetists on the subject of TTA: why this perspective is needed, the effect of the limb length, the incision techniques used, new alternatives in postoperative treatment, and its impact on early prosthetic fitting, within a Swedish context. Methodology:To address this aim, each section was discussed individually, summarizing relevant evidence from a professional perspective, using various evidence sources (e.g., peer-reviewed literature, and national patient registries).Findings: From the authors' view, when using modern postoperative treatment and prosthetic technology, the Sagittal Incision (SF) incision may be beneficial to Posterior Flap (PF) incision in TTA, if the aim is to reduce the time to prosthetic fitting.New postoperative treatment methods are being made more accessible and recognized.This might not be a valid solution in all places, but they contribute to the evidence base used for decision-making following TTAs. Conclusion:From a Prosthetist perspective, more could be done to improve the pathway from amputation to prosthetic fitting and ensure the best functional outcome for the patient.Traditional methods from the 1950s have been discussed, and other alternatives have been contrasted.