Preservation of functional capacity in short-stump transtibial amputation: A cross-sectional study

and objectives: Several strategies are used to improve prosthetic fitting in tibial amputees with a short stump, including proximal re-amputation, residual bone lengthening, or adjustment of prosthetic components, although evidence for the latter remains limited. This study aims to examine whether short below-knee (BK) amputation levels maintain functional capacity compared with standard-length transtibial amputations. Twelve patients with BK amputation were included: six with a short residual limb and six with a standard-length limb, all managed in the amputee unit of the Physical Medicine and Rehabilitation Service of our center. Recorded variables were age, sex, stump length, and prosthesis type. Functional capacity was assessed using the 6-minute walk test (6MWT), Timed Up and Go (TUG), the 10-meter walk test (10MWT), and the Pohjolainen scale. The Mann–Whitney U test was applied for quantitative variables and Fisher’s exact test for qualitative variables. Analyses were performed using SPSS version 26. Both groups completed the 6MWT with a global median of 391.8 m (SD 97.17; p=0.310). In the 10MWT the median for the total group was 1.437 m/s (SD 0.265; p=0.699). In the TUG the overall median was 8.596 s (SD 2.3994; p=1). On the Pohjolainen scale for this population sample, the result was not binding (p=1). No significant differences in functional capacity were observed between short and standard BK residual limbs. These findings support short BK amputation as a viable option that may avoid unnecessary bone lengthening or more proximal re-amputation. • Amputation level and residual limb morphometry are crucial for functional prognosis. • Knee joint preservation reduces energy expenditure and enables a more physiological gait. • Optimizing prosthetic components for patients with short residual limbs improves functional level. • A femoral corset and external articulation enhance suspension by elevating the socket's medial and lateral walls.