Amputation of the Leg

Whether or not the soleus muscle should be excised during below-knee amputation is a point of contention. The anatomical basis for the blood supply to the skin of the posterior calf has been examined by dissection and selective arterial injection of cadavers. The results showed that the skin used to construct the posterior flap for below-knee amputation derives its blood supply from both axial vessels, running with the peripheral nerves, and perforating vessels arising through the gastrocnemius muscle. There is no contribution by blood vessels that pass through the soleus muscle. When a posterior flap for below-knee amputation is constructed the soleus muscle should be completely excised.

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Amputation for occusive arterial disease

Eneroth

Persson

1992

International Orthopaedics

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All major amputations of the lower limb due to occlusive arterial disease were studied prospectively and consecutively during one year in the 5 hospitals in Malmöhus county, Sweden. The patients were followed for 6 months after the primary amputation of which 136 were through the tibia, 6 through the knee and 35 through the femur. One hundred and seventy-seven patients (92 men and 85 women) were included; 49% were 80 years or older and 40% were diabetic. At 6 months, 85 of the surviving 109 patients had healed stumps, 10 were not healed and 14 had been revised or reamputated. Half the survivors used a prosthesis daily. There was no significant difference in healing related to sex, age, diabetes or the level of amputation, but diabetics were more often bilateral amputees. The mortality at 6 months was 38% and at 4 years 72%.

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Amputation of the Leg

Cited by 14 publications

References 4 publications

Morbid Implications of Above-Knee Amputations

Morbid Implications of Above-Knee Amputations

Anatomical aspects of the blood supply to the skin of the posterior calf: Technique of below-knee amputation

Amputation for occusive arterial disease

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