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Rehabilitation for Lower Extremity Amputation

Rehabilitation for Lower Extremity Amputation Abstract • The results of rehabilitation for lower-extremity amputation were analyzed to assess the impact of a center that used a coordinated team combined with modern surgical and prosthetic techniques. Data for group 1 patients (amputated between July 1, 1975, and June 30, 1977) demonstrated a healing rate of 63%, a mean rehabilitation time of 128 days, a mean hospitalization time of 68 days, and a rehabilitation rate of 69% for those who could walk prior to amputation. Data for group 2 (amputated between July 1, 1977, and July 30, 1979) demonstrated an amputation healing rate of 97%, an average rehabilitation time of 30.8 days, a mean hospitalization time of 38 days, and a rehabilitation rate of 100% for those patients who could walk before amputation. There was no difference between groups 1 and 2 in surgical mortality; all other variables, however, showed significant improvement for group 2 patients. Comparison within the same institution of the results of rehabilitation for lower-extremity amputation before and after the initiation of a dedicated amputation center clearly demonstrated the superiority of the center concept. (Arch Surg 116:93-98, 1981) References 1. Burgess EM, Romano RL: The management of lower extremity amputees using immediate postsurgical prostheses . Clin Orthop 1968;57:137-146. 2. Burgess EM, Romano RL, Zettl JH, et al: Amputation of the leg for peripheral vascular insufficiency . J Bone Joint Surg Am 1971;53:874-890. 3. Christensen S: Lower extremity amputation in the County of Aalborn, 1961-1971: Population study and follow-up . Acta Orthop Scand 1976;47:329-334.Crossref 4. Engstrand SL: Rehabilitation of the patient with a lower extremity amputation . Nurs Clin North Am 1976;11:659-669. 5. Jamieson CW, Hill D: Amputation for vascular disease . Br J Surg 1974;63:683-686.Crossref 6. LeBlanc MA: Patient population and other estimates of prosthetics and orthotics in the USA . Orthot Prosthet 1973;27:38-44. 7. Lipp MR, Malone SJ: Group rehabilitation of vascular surgery patients . Arch Phys Med Rehabil 1976;57:180-183. 8. Lippman HI, Clippinger F, Friz BR, et al: Hospital resources for a quality amputation program . Circulation 1972;46(appendix):293-304. 9. Malone JM, Moore WS, Goldstone J, et al: Therapeutic and economic impact of a modern amputation program . Ann Surg 1979;189:798-802.Crossref 10. Moore WE, Hall AD, Lim RD Jr: Below knee amputation for ischemic gangrene . Am J Surg 1972;124:127-134.Crossref 11. Moore WS, Hall AD, Wylie EJ: Below knee amputation for vascular insufficiency: Experience with immediate postoperative fitting with prostheses . Arch Surg 1968;97:886-893.Crossref 12. Moore WS, Malone JM, Henry RE, et al: Amputation level determination using xenon 133 clearance. Scand J Clin Lab Invest, to be published. 13. Roon AJ, Moore WS, Goldstone J: Below-knee amputation: A modern approach . Am J Surg 1977;134:153-158.Crossref 14. Harris PL, Read F, Eardley A, et al: The fate of elderly amputees . Br J Surg 1974;61:665-668.Crossref 15. Lim RC Jr, Blaisdell FW, Hall AD: Below knee amputation for ischemic gangrene . Surg Gynecol Obstet 1967;25:493-501. 16. Moore WS: Determination of amputation level: Measurement of skin blood flow with xenon 133 . Arch Surg 1973;107:798-802.Crossref 17. Daly MJ, Henry RE, Patton DD: Measurement of skin perfusion with xenon 133 . J Nucl Med 1978;19:709. 18. Daly MJ, Henry RE, Malone JM, et al: Quantitative measurement of skin perfusion with xenon 133. J Nucl Med, to be published. 19. Leal JM, Malone JM, Moore WS, et al: Accelerated rehabilitation postamputation: Xoroc prosthesis. Am J Prosthet, to be published. 20. Kegel B: Controlled environmental treatment (CET) for patients with below-knee amputation . Phys Ther 1976;56:1366-1371. 21. Cohen SI, Goldman LD, Salzman EW, et al: The deleterious effect of immediate postoperative prosthesis in below knee amputation for ischemic disease . Surgery 1974;76:997-1001. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Rehabilitation for Lower Extremity Amputation

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References (19)

Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1981.01380130069016
Publisher site
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Abstract

Abstract • The results of rehabilitation for lower-extremity amputation were analyzed to assess the impact of a center that used a coordinated team combined with modern surgical and prosthetic techniques. Data for group 1 patients (amputated between July 1, 1975, and June 30, 1977) demonstrated a healing rate of 63%, a mean rehabilitation time of 128 days, a mean hospitalization time of 68 days, and a rehabilitation rate of 69% for those who could walk prior to amputation. Data for group 2 (amputated between July 1, 1977, and July 30, 1979) demonstrated an amputation healing rate of 97%, an average rehabilitation time of 30.8 days, a mean hospitalization time of 38 days, and a rehabilitation rate of 100% for those patients who could walk before amputation. There was no difference between groups 1 and 2 in surgical mortality; all other variables, however, showed significant improvement for group 2 patients. Comparison within the same institution of the results of rehabilitation for lower-extremity amputation before and after the initiation of a dedicated amputation center clearly demonstrated the superiority of the center concept. (Arch Surg 116:93-98, 1981) References 1. Burgess EM, Romano RL: The management of lower extremity amputees using immediate postsurgical prostheses . Clin Orthop 1968;57:137-146. 2. Burgess EM, Romano RL, Zettl JH, et al: Amputation of the leg for peripheral vascular insufficiency . J Bone Joint Surg Am 1971;53:874-890. 3. Christensen S: Lower extremity amputation in the County of Aalborn, 1961-1971: Population study and follow-up . Acta Orthop Scand 1976;47:329-334.Crossref 4. Engstrand SL: Rehabilitation of the patient with a lower extremity amputation . Nurs Clin North Am 1976;11:659-669. 5. Jamieson CW, Hill D: Amputation for vascular disease . Br J Surg 1974;63:683-686.Crossref 6. LeBlanc MA: Patient population and other estimates of prosthetics and orthotics in the USA . Orthot Prosthet 1973;27:38-44. 7. Lipp MR, Malone SJ: Group rehabilitation of vascular surgery patients . Arch Phys Med Rehabil 1976;57:180-183. 8. Lippman HI, Clippinger F, Friz BR, et al: Hospital resources for a quality amputation program . Circulation 1972;46(appendix):293-304. 9. Malone JM, Moore WS, Goldstone J, et al: Therapeutic and economic impact of a modern amputation program . Ann Surg 1979;189:798-802.Crossref 10. Moore WE, Hall AD, Lim RD Jr: Below knee amputation for ischemic gangrene . Am J Surg 1972;124:127-134.Crossref 11. Moore WS, Hall AD, Wylie EJ: Below knee amputation for vascular insufficiency: Experience with immediate postoperative fitting with prostheses . Arch Surg 1968;97:886-893.Crossref 12. Moore WS, Malone JM, Henry RE, et al: Amputation level determination using xenon 133 clearance. Scand J Clin Lab Invest, to be published. 13. Roon AJ, Moore WS, Goldstone J: Below-knee amputation: A modern approach . Am J Surg 1977;134:153-158.Crossref 14. Harris PL, Read F, Eardley A, et al: The fate of elderly amputees . Br J Surg 1974;61:665-668.Crossref 15. Lim RC Jr, Blaisdell FW, Hall AD: Below knee amputation for ischemic gangrene . Surg Gynecol Obstet 1967;25:493-501. 16. Moore WS: Determination of amputation level: Measurement of skin blood flow with xenon 133 . Arch Surg 1973;107:798-802.Crossref 17. Daly MJ, Henry RE, Patton DD: Measurement of skin perfusion with xenon 133 . J Nucl Med 1978;19:709. 18. Daly MJ, Henry RE, Malone JM, et al: Quantitative measurement of skin perfusion with xenon 133. J Nucl Med, to be published. 19. Leal JM, Malone JM, Moore WS, et al: Accelerated rehabilitation postamputation: Xoroc prosthesis. Am J Prosthet, to be published. 20. Kegel B: Controlled environmental treatment (CET) for patients with below-knee amputation . Phys Ther 1976;56:1366-1371. 21. Cohen SI, Goldman LD, Salzman EW, et al: The deleterious effect of immediate postoperative prosthesis in below knee amputation for ischemic disease . Surgery 1974;76:997-1001.

Journal

Archives of Surgery – American Medical Association

Published: Jan 1, 1981

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