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A TRIAL OF FLAPLESS BELOW‐KNEE AMPUTATION FOR ARTERIAL INSUFFICIENCY
Author(s) -
Little J. M.,
Stewart G. R.,
Niesche F. W.,
Williams C.
Publication year - 1970
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1970.tb116742.x
Subject(s) - amputation , medicine , rehabilitation , popliteal artery , arteriosclerosis obliterans , knee joint , surgery , lower limb amputation , artery , physical therapy
Two groups of patients with severe lower‐limb ischæmia caused by atherosclerosis obliterans have been compared in an evaluation of the merits and disadvantages of below‐knee and above‐knee amputation. Below‐knee amputations were performed using a no‐flap technique. Patients were selected for their rehabilitation potential, and all were thought suitable for below‐knee amputation on clinical grounds alone; the position of the lowest pulse was not used for selection; nor was arteriography. The two groups were shown to be comparable clinically, except that electrocardiographically proven coronary‐artery disease was more common in the below‐knee amputees. There was no difference in the morbidity or mortality of the two groups. The length of hospital stay, determined by the amputation, was the same for both groups. There was, however, a significant advantage in the rehabilitation status achieved by the below‐knee amputees, a higher proportion of whom achieved “good” rehabilitation. Below‐knee amputation should be carried out for all patients whose trophic changes permit it, and above‐knee amputation reserved for the desperately ill, and for those with more proximal trophic changes.