The conventional amputation procedure, sometimes referred to as the ‘long-posterior flap’ method, is currently completed using the same methods as amputations were done in the days of the early part of the century (and before), only with better instruments and medications:
In a below knee amputation procedure, the tibia and fibula (two bones in the lower leg) aren’t secured to each other, which allows them to ‘chop stick’ (move about) within the residual limb (‘stump’), which can cause varying levels of pain on different days.
Within the Osteomyoplasty Amputation (Etrl) procedure, much more time is taken by the surgeon to ensure the residual limb is prepared for a future prosthetic device. During the procedure:
There is also a considerable time difference between the two procedures … a conventional takes approximately 60-90 minutes while the Ertl needs approximately 2.5-4 hours (depending if it is a primary or revision surgery and the physical state of the limb). But considering the end results, that short amount of time (in the long run) is well worth the increased potential for returning to a high level of activity.
During all of my research, I have found numerous amputees that have had to undergo revisions (additional surgeries) and used the Ertl procedure to fix/improve the conventional procedure they originally received. I have never found an Ertl amputee that had to use a conventional procedure for revision.