title: The Below-Knee Amputation: To Amputate or Palliate?
abstract: CONCLUSIONS
  A below-knee amputation (BKA) can be the most functional option for select patients with a diseased lower extremity and may offer a better quality of life than limb salvage in some patients.
  
  
  BACKGROUND
  Because of advances in prosthetic technology, some patients may have a better quality of life with a BKA than a salvaged lower extremity. Those who cannot wear a prosthesis will do better with a poorly functioning leg. Understanding which patients will not benefit from an amputation helps ensure that a maximum of patients will continue ambulating.
  
  
  RESULTS
  We lack a thorough understanding of which patients will be more functional with a BKA than a salvaged extremity. Some will do better with a prosthesis, whereas others will do better with a poorly functioning peg leg. This is because so many amputees never wear their prosthesis.
  
  
  CONCLUSIONS
  A better understanding of patient selection and optimal operative technique would allow us to better council patients as to how to optimize their functional outcome. Over the past 30 years, a number of useful studies have been published regarding the BKA. However, recent advances in wound care, prosthetics, and medical care in general require a re-evaluation of the BKA within the limb salvage concept.
authors: Center for Wound Healing, Georgetown University Hospital , Washington, District of Columbia.
authors: Benjamin J
authors: BJ
authors: Brown
authors: Center for Wound Healing, Georgetown University Hospital , Washington, District of Columbia.
authors: Christopher E
authors: CE
authors: Attinger