Bedsores Resulting in Below the Knee Amputations / Transtibial Amputation


Information About Transtibial Amputation

AmputationThere are roughly 2 million people in the United States living with a limb loss. The most common age group associated with transtibial amputations is 65 years and older.

A below-knee amputation, also known as a transtibial, a between the knee and ankle amputation, can be required when a patient has an infection. Below the knee amputations are the most common amputation injury procedure.

Infected pressure sores can result in below the knee amputations. Pressure sores (also known as bedsores, decubitus ulcers and pressure ulcers) are preventable breakdowns of the skin. The elderly nursing home population is very susceptible to developing bedsores.

Most nursing home residents are unable to move or have restricted movement. Elderly residents that are wheelchair bound or bedridden are not able to move or reposition their bodies and therefore cannot shift the pressure beds and wheels chairs place on parts of their bodies. As a result, pressure builds on certain parts of the body like the back of the head from a pillow or the sacrum/tailbone/low back, heels, elbows, shoulder blades from a bed mattress. Extended periods of pressure reduces the blood supply to these areas of the body which kills skin cells causing the to skin breakdown.

Pressure sores develop when the skin breaks down.

Once the skin breaks down the pressure ulcer wound can get infected with sepsis (blood infection), gangrene, osteomyelitis (bone infection), joint infection, MRSA (bacterial infection) or necrotizing fasciitis (flesh-eating disease). In extreme cases where the infection is deep an amputation might be required to prevent the infection from spreading from the bedsore to the rest of the body.

Pre-Surgery and Post-Surgery Considerations

Most below-knee amputations (BKA) are performed in area between the ankle and kneecap. The diseased or severely injured part of the limb is removed, preserving as much healthy tissue and bone as possible, and the surgeon then shapes the remaining limb to allow for use of a prosthetic leg. Generally speaking several inches of leg below the knee most remain in order fit an artificial leg.

Before surgery, patients may need to perform preoperative exercises and obtain some education about the procedure and follow-up. Following the surgery, it is important that the patient does specific exercises in order to prevent tightening of the muscles and change bandages frequently, as well. This type of amputation does not typically result in a disabling condition, especially given modern prostheses and treatments. However, it is important that surgeons preserve the knee joint when possible and ensure that the stump is as low as possible, as this is best for prosthetics and circulation. Edema can become an issue and can make fitting the prosthesis more difficult, although it can be controlled, to a certain extent, by more rigid dressing following the surgery.


Most prostheses for below the knee amputations consist of a socket, shank, and foot. When it comes to fitting a prosthetic, the alignment of the various parts and the fitting of the socket are extremely important. The patient will also need a certain degree of training so that he or she can attain a certain level of comfort and functionality. Typically, a preparatory prosthesis used immediately after surgery in order to prevent edema and until the stump is stabilized, whereby a permanent prosthesis is then provided. A prosthetic sock or sheath is also worn to provide for ventilation and protect the skin.

Training is not only necessary in terms of fitting trials, but physical therapy is also necessary in order to strengthen performance and comfort. It is important that patients also wash the stumps and interior of the plastic sockets daily in order to avoid irritation and infection, and note that adjustments of the prosthesis will likely be necessary in the first year of wearing it.

What Can You Do if You Suspect a Nursing Home is Liable for a Loved One’s Amputation?

Sometimes a nursing home is liable for your loved one’s injuries and their resulting complications, including death. When a nursing home neglects patient needs, including their medical needs related to bedsores, they may have committed a type of medical malpractice for which you can seek compensation.

If you believe your loved one has suffered a medical condition, amputation, or has died because of complications related to bedsores or other forms of nursing home neglect, contact our experienced and compassionate nursing home neglect lawyers today for a free consultation.

Nursing Home Neglect Lawyers, Boston MA

We offer a free, no-obligation legal consultation to help you understand your rights and the value of your case. Our personal injury law firm takes cases involving elder abuse and neglect. We offer legal service to clients in Massachusetts, Rhode Island and New Hampshire.

Massachusetts Attorneys for Ankle Amputation Surgery Resulting from Nursing Home Neglect and Abuse

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