title: Functional outcome of below-knee amputation in peripheral vascular insufficiency. A multicenter review.
abstract: A retrospective functional outcome study was performed on 299 patients treated with below-knee amputations for peripheral vascular disease during a three-year period in six Veterans Administration special amputee centers. Sixty-one percent of the patients were diabetic, and 25% were previously unilateral amputees. Surgery was performed with a long posterior flap in 92.3%, sagittal flaps in 20%, and guillotine open technique in 5.7%. Wound management was accomplished with rigid plaster dressings in 75.3%, pneumatic compression dressing in 14%, and soft dressings in 10.7%. At follow-up evaluation one to two years later, 36.1% had died. Thirteen percent suffered wound complications, with 6.7% requiring revision to a more proximal amputation level. Eighty-seven percent of community ambulators maintained their ambulatory status. A comparable percentage maintained their ability to walk with a prosthesis.
authors.affiliation: Special Teams for Amputations, Mobility, Prosthetics/Orthopaedics (STAMP) Centers, VA Hines, Illinois.
authors.forename: M S
authors.initials: MS
authors.lastname: Pinzur
authors.forename: F
authors.initials: F
authors.lastname: Gottschalk
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Shanfield
authors.forename: R
authors.initials: R
authors.lastname: de Andrade
authors.forename: H
authors.initials: H
authors.lastname: Osterman
authors.forename: J R
authors.initials: JR
authors.lastname: Roberts
authors.forename: P
authors.initials: P
authors.lastname: Orlando-Crombleholme
authors.forename: J
authors.initials: J
authors.lastname: Larsen
authors.forename: P
authors.initials: P
authors.lastname: Rappazzini
mesh_terms: D000671:Amputation, Surgical / Q000534:rehabilitation*; D003925:Diabetic Angiopathies / Q000601:surgery; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000601:surgery*