Fig 18A-8. Levels of transtibial amputation. The very short level must include the tibial tubercle. With sufficient vascularity, residual limbs with bone transection levels just proximal to the metaphyseal flare can be very functional. (From Epps CH: Amputation of the lower limb, in Evarts CM (ed): Surgery of the Musculoskeletal System, ed 2 New York, Churchill Livingstone Inc, 1990. Used by permission.)