The Differences Between Transtibial and Transfemoral Amputations

The clinical director of Physio Orthotic & Prosthetic in Milwaukee, Wisconsin, Paul Leimkuehler holds a bachelor of science in marketing from Miami University in Oxford, Ohio, and a certificate in prosthetics and orthotics from Northwestern University in Chicago, Illinois. Working with a range of artificial limbs and braces, Paul Leimkuehler is highly knowledgeable about both transtibial and transfemoral amputations.

Transtibial (or below the knee) amputations are the most common major limb amputation in the United States. Most surgeons who perform this type of amputation will create a muscular flap from the gastrocnemius and soleus muscles, wrap these muscles under the remaining tibia bone, and secure the flap to the anterior tibia by suture.

Transfemoral amputations take place above the knee, but attempt to leave as much residual limb as possible. The length of the residual femur can make a big difference in energy expenditure when a patient begins walking with a prosthetic limb. While medical professionals have traditionally thought that transfemoral amputees have greater gait asymmetries than transtibial amputees, a recent study has found that, in terms of spatial asymmetry, little difference exists between them.