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Below-Knee Amputation in Patients With Diabetes Mellitus

Below-Knee Amputation in Patients With Diabetes Mellitus Abstract Necrosis of large areas of the foot due to gangrene or infection, or both, related etiologically to occlusive vascular disease and neuropathy in patients with diabetes mellitus is a common problem. When amputation of the foot is indicated, it has often been considered necessary to amputate at the thigh level. Experience in recent years has proved to us that the below-knee amputation is usually feasible in these patients. The advantages of a below-knee level of amputation are several: walking with a prosthesis is easier, rehabilitation is facilitated, less strain is placed on a remaining foot, and even wheelchair and bed mobility is better. This report deals with 40 patients for whom 43 below-knee amputations have been managed personally. The first operation, performed in 1955, resulted in the selection of the below-knee level in an increasing number of patients subsequently. Three of the patients have required bilateral below-knee amputations. Conservative Attitude References 1. Goldenberg, S.; Alex, M.; Joshi, R. A.; and Blumenthal, H. T.: Nonatheromatous Peripheral Vascular Disease of the Lower Extremity in Diabetes Mellitus , Diabetes 8:261-273, 1959. 2. Silbert, S., and Haimovici, H.: Results of Midleg Amputations for Gangrene in Diabetics , JAMA 144:454-458, 1950.Crossref 3. Hoar, C. S., Jr., and Torres, J.: Evaluation of Below the Knee Amputation in the Treatment of Diabetic Gangrene , New Eng J Med 266:440-443, 1962.Crossref 4. Harris, P. D.; Schwartz, S. I.; and DeWeese, J. A.: Midcalf Amputation for Peripheral Vascular Disease , Arch Surg 82:381-383, 1961.Crossref 5. Tolstedt, G. E., and Bell, J. W.: Failure of Below-Knee Amputation in Peripheral Arterial Disease , Arch Surg 83:834-936, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Below-Knee Amputation in Patients With Diabetes Mellitus

Archives of Surgery , Volume 87 (4) – Oct 1, 1963

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Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1963.01310160144029
Publisher site
See Article on Publisher Site

Abstract

Abstract Necrosis of large areas of the foot due to gangrene or infection, or both, related etiologically to occlusive vascular disease and neuropathy in patients with diabetes mellitus is a common problem. When amputation of the foot is indicated, it has often been considered necessary to amputate at the thigh level. Experience in recent years has proved to us that the below-knee amputation is usually feasible in these patients. The advantages of a below-knee level of amputation are several: walking with a prosthesis is easier, rehabilitation is facilitated, less strain is placed on a remaining foot, and even wheelchair and bed mobility is better. This report deals with 40 patients for whom 43 below-knee amputations have been managed personally. The first operation, performed in 1955, resulted in the selection of the below-knee level in an increasing number of patients subsequently. Three of the patients have required bilateral below-knee amputations. Conservative Attitude References 1. Goldenberg, S.; Alex, M.; Joshi, R. A.; and Blumenthal, H. T.: Nonatheromatous Peripheral Vascular Disease of the Lower Extremity in Diabetes Mellitus , Diabetes 8:261-273, 1959. 2. Silbert, S., and Haimovici, H.: Results of Midleg Amputations for Gangrene in Diabetics , JAMA 144:454-458, 1950.Crossref 3. Hoar, C. S., Jr., and Torres, J.: Evaluation of Below the Knee Amputation in the Treatment of Diabetic Gangrene , New Eng J Med 266:440-443, 1962.Crossref 4. Harris, P. D.; Schwartz, S. I.; and DeWeese, J. A.: Midcalf Amputation for Peripheral Vascular Disease , Arch Surg 82:381-383, 1961.Crossref 5. Tolstedt, G. E., and Bell, J. W.: Failure of Below-Knee Amputation in Peripheral Arterial Disease , Arch Surg 83:834-936, 1961.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1963

References