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September 1965

Midcalf Amputation in the Ischemic ExtremityUse of Lateral and Medial Flap

Author Affiliations

From the Department of Surgery, Wayne State University, and Detroit Memorial, Grace, Harper, Providence, and Woman's hospitals.

Arch Surg. 1965;91(3):506-508. doi:10.1001/archsurg.1965.01320150136026

WHEN AN amputation is necessary, rehabilitation can be more frequent and successful with a midcalf than with a supracondylar amputation. Many advantages are available to the patient with a below-theknee amputation.5 He can more readily turn in bed, support himself on the knee, and control his prosthesis. The older patient will frequently use a below-knee prosthesis, whereas an above-knee prosthesis is often impractical and is discarded.

Blood supply is better and healing is more certain with the thick medial and lateral flap. Careful selection4,8 of the patient for the midcalf amputation and utilization of methods to increase the chances of primary healing would seem to minimize failure.1,6

Fifteen patients out of 20 requiring leg amputations were selected for amputation in the midcalf. Medial and lateral flaps were used in all amputations at this level. A 100% healing was obtained including delayed healing in three cases. No deaths

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