Subtalar Disarticulation and Transtalar Amputation

Hancock stated subtalar disarticulation was suggested by Lignerolles, first performed by Textor in 1841 and promulgated by Malgaine in 1846 (Fig. 11.2).28 Lateral, medial, posterolateral and posterior flaps were attempted to ameliorate results but retention of the talus proved troublesome, usually causing an equinus attitude and pressure of the talar head against foot prostheses. In 1864, Hancock excised the talar head and applied a sliver of cancellous calcaneum (see Fig. 11.2, D),

Syme Amputation

Fig. 11.2. Sagittal sections of lower shin and foot to show hind-foot amputations. A. Syme's stump removing foot, malleoli and thin section of tibia. B. Pirigov's stump is similar but retains the calcaneal tuberosity applied to cut tibial surface. C. Lignerolle's stump retaining talus and ankle joint. D. Hancock's stump retaining body of talus and calcaneal tuberosity. (From Kirkup J. Foot amputations: (2) Hindfoot. Foot 1994;4:117-119.28)

Fig. 11.2. Sagittal sections of lower shin and foot to show hind-foot amputations. A. Syme's stump removing foot, malleoli and thin section of tibia. B. Pirigov's stump is similar but retains the calcaneal tuberosity applied to cut tibial surface. C. Lignerolle's stump retaining talus and ankle joint. D. Hancock's stump retaining body of talus and calcaneal tuberosity. (From Kirkup J. Foot amputations: (2) Hindfoot. Foot 1994;4:117-119.28)

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