July 1971

Life and Limb

Arch Surg. 1971;103(1):3. doi:10.1001/archsurg.1971.01350070029004

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The winds of change are blowing. In our approch to amputations of the leg for gangrene, a new philosophy has emerged. Where before surgeons were saving lives by mid-thigh amputations with little heed to later walking, now we are aiming at saving the limb, or at least the part of it most vital for walking—the knee joint. Our objective is early walking independence, hopefully at home, rather than a wheel chair in a chronic care institution. In 1964, the ratio of below-knee to above-knee amputations in a survey made in a group of 14 Veterans Administration hospitals was 0.41. In 1967 in 23 VA hospitals, it was 0.70. In the earlier survey, the mean time of rehabilitation to walking with a prosthesis for above knees was 13 weeks; for below knees, 16 weeks. In the 1967 survey, it was less than 12 weeks for both levels. This illustrates the trend

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