The Ertle

I am still sore from my tumble the other day. How I managed to "forget" to put my leg on still astounds me. I am lucky that, aside from hurting my pride, I only sustained multiple bruises. I know that it could have been much worse.

When I had my amputation, my surgeon proposed doing an "ertle" procedure, also known as a bone bridge. Not knowing surgical procedures, I trusted in the expert. He seemed confident that this type of amputation was both proactive and necessary, so I consented.

I am by no means a surgeon, but this is my understanding of the Ertle procedure. With most bk amputations, the tibia and the fibula bones are severed. A skin flat is brought over the bones, creating a stump. Although certainly not impossible, it is difficult and painful for individuals with this type of amputation to bear weight directly on the bottom of their stump.

With an amputation done using the Ertle procedure, the tibia and fibula are joined by a piece of bone screwed into place. The bones eventually fuse giving the resulting stump a wider base. The wider stump makes it easier for me to bear weight on the bottom of my limb and it also makes my stump less sensitive, thus it is easier to fit me with a prosthetic.

The bone bridge procedure has some initial drawbacks. Firstly, it requires more surgical skill to perform than the basic amputation. Not all surgeons are competent in this procedure. I am lucky that mine is proficient. Since the procedure is more complex it requires the patient to be in the operating room for a longer period of time.

The biggest negative to the procedure is a follow-up surgery to remove the screw approximately six months after the amputation. I can tell you, six months after my amputation the last thing I wanted to do was to see my surgeon in the operating room again! I was just starting to ambulate and was less than thrilled about a follow-up procedure, albeit "simple."

I am thankful that my surgeon insisted on the Ertle procedure for my amputation. I do not have the prosthetic stress experienced by many amputees. In fact, I am quite easy to fit with a prosthetic. I have yet to have an issue with the bottom of my limb.

The base of my stump can withstand both weight and impact. I fell onto the base of my stump and sustained only bruising. My stump is sore, but I am still able to wear my prosthetic. Life as an amputee is not easy, but the Ertle procedure has made it easier. For this, I am thankful.