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Context: Little is known about the energy expenditure following limb salvage with tibiocalcaneal (TC) or tibio-talo-calcaneal (TTC) fusions and optimization of leg lengths. Studies have quantified the energy expenditures of amputees and tibiotalar fusion patients by measuring oxygen (O 2 ) consumption, but a similar study has yet to be performed on TC or TTC fusion patients. Since limb salvage with TC or TTC fusion is often considered an alternative treatment to a below the knee amputation (BKA), it will be useful to understand the relative energy expenditures of the two treatment groups. Aims: To assess the energy expenditure and self-reported outcomes of patients who have undergone limb salvage with TC or TTC fusions, and to compare the O 2 consumption of TC and TTC fusion patients to those reported in the literature for patients who underwent BKAs. Subjects and Methods: We gathered data on 12 TC and TTC fusion patients′ O 2 consumptions at rest, their self-selected usual daily walking speed (UDWS), 80% of UDWS, 120% of UDWS, and a fixed speed of 2 miles/h (mph). Short form-36 (SF-36) and visual analog scores were also obtained. Statistical Analysis: We calculated the averages and standard deviations of the O 2 consumption levels for our cohort of TC and TTC fusion patients. Results: The TTC and TC patients overall averaged 10.4 mL O 2 /min/kg at an average UDWS of 1.9 mph. This O 2 consumption rate was 22% higher than normal. The outcome SF-36 scores were 57 and 45 for the mental and physical components, respectively. The visual analog scale was 1.1. Conclusion: Patients after TC and TTC fusions have minimal pain. SF-36 mental component scores were better than those of normal population, and physical component scores were minimally lower than the normal population. While O 2 consumptions was 22% above normal population, it was less than what has been reported in the literature for BKA patients.

Oxygen consumption testing and self-reported outcomes following limb salvage with tibiocalcaneal or tibio-talo-calcaneal fusion