A prospective randomized comparison of healing in Gritti-Stokes and through-knee amputations.
Twenty-two patients with a median age of 79 years had 24 amputations about knee joint level. The patients were randomised to undergo either Gritti-Stokes or through-knee amputations. In two-thirds of limbs transcutaneous oxygen was less than 4.65 KPa (35 mmHg) or there were no audible Doppler signals at the ankle, indicating that a below-knee amputation would have been at risk of failing to heal, and in the remainder an amputation at the knee joint was considered the preferable site for a variety of reasons. Nine of 12 (75%) Gritti-Stokes amputations underwent uncomplicated primary healing compared with only 2 of 12 (17%) through-knee procedures (P = 0.04). Two through-knee amputations required revision to above the knee (17%) while all Gritti-Stokes amputations healed. Three patients in each group became mobile on a prosthesis, the remainder being bilateral amputees or unable to manage an artificial limb.
D000368:Aged; D000671:Amputation, Surgical / Q000379:methods* / Q000534:rehabilitation; D000672:Amputation Stumps / Q000503:physiopathology; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000534:rehabilitation; D011446:Prospective Studies; D019736:Prostheses and Implants; D011897:Random Allocation; D014652:Vascular Diseases / Q000601:surgery*; D014945:Wound Healing