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Article
January 24, 1920

"AMPUTATION ABOVE THE LEVEL OF ARTERIAL OBSTRUCTION IN ARTERIOSCLEROTIC GANGRENE"

JAMA. 1920;74(4):267. doi:10.1001/jama.1920.02620040051026

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Abstract

To the Editor:  —In The Journal, Dec. 6, 1919, p. 1760, Drs. Eisendrath and Bettman suggested that in arteriosclerotic gangrene (thrombo-angeitis obliterans) it would be advisable to amputate above the level of arterial obstruction, such obstruction to be determined by preliminary exposure of the femoral artery. It is recommended that the artery be ligated in its pulsating portion, and that amputation be performed at the same level. Reference is made to a case in which this was done, and diagrams show the presence of a thrombus in the common femoral artery and the point of ligation above the thrombus just below Poupart's ligament. In spite of the high amputation, there was some gangrene of the flaps.This condition is one in which the surgeon after the operation frequently feels that whatever may have been the level he has chosen for the amputation, he has erred. If he obtains primary union

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