title: Controversies in amputation surgery.
abstract: Amputation surgery should be the first step in the rehabilitation of a patient with a nonfunctional limb, rather than the final step in treatment. When faced with a difficult decision regarding lower extremity amputation compared with attempted limb reconstruction, expectations for a reasonable outcome must be determined. After reasonable goals have been set, the surgery should be directed toward interfacing with a prosthetic limb. Current surgical techniques of lower extremity amputation, paying special attention to transosseous versus disarticulation amputation, help to optimize prosthetic limb fitting and functional rehabilitation. With the evolution of end-bearing amputation levels, there is resurgent interest in the bone bridging technique of Johann Ertl and interest in a new pneumatic immediate postoperative prosthetic limb fitting system.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Pinzur
authors.forename: Marco A Guedes de Souza
authors.initials: MA
authors.lastname: Pinto
authors.forename: Lew C
authors.initials: LC
authors.lastname: Schon
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Smith
mesh_terms: D000671:Amputation, Surgical / Q000379:methods* / Q000534:rehabilitation; D001186:Artificial Limbs; D003657:Decision Making; D004188:Disarticulation; D006801:Humans; D007866:Leg; D023821:Limb Salvage; D011474:Prosthesis Design