Article

This literature review was undertaken to determine if commonly held
views about the benefits of a bone bridge technique are supported by the
literature. METHODS: Four databases were searched for articles pertaining to
surgical strategies specific to a bone bridge technique of the transtibial
amputee. A total of 35 articles were identified as potential articles. Authors
included methodology that was applied to separate topics. Following
identification, articles were excluded if they were determined to be low quality
evidence or not pertinent. RESULTS: Nine articles were identified to be pertinent
to one of the topics: Perioperative Care, Acute Care, Subjective Analysis and
Function. Two articles sorted into multiple topics. Two articles were sorted into
the Perioperative Care topic, 4 articles sorted into the Acute Care topic, 2
articles into the Subjective Analysis topic and 5 articles into the Function
topic. DISCUSSION: There are no high quality (level one or two) clinical trials
reporting comparisons of the bone bridge technique to traditional methods. There
is limited evidence supporting the clinical outcomes of the bone bridge
technique. There is no agreement supporting or discouraging the perioperative and
acute care aspects of the bone bridge technique. There is no evidence defining an
interventional comparison of the bone bridge technique. CONCLUSION: Current level
III evidence supports a bone bridge technique as an equivalent option to the
non-bone bridge transtibial amputation technique. Formal level I and II clinical
trials will need to be considered in the future to guide clinical practice.
Clinical relevance Clinical Practice Guidelines are evidence based. This
systematic literature review identifies the highest quality evidence to date
which reports a consensus of outcomes agreeing bone bridge is as safe and
effective as alternatives. The clinical relevance is understanding bone bridge
could additionally provide a mechanistic advantage for the transtibial amputee.

Langue : ANGLAIS