To the Editor.—Although they seem reluctant to say so explicitly, what Gibbons et al have demonstrated in their article, "Predicting Success of Forefoot Amputations in Diabetics by Noninvasive Testing" (Archives 114:1034-1036, 1979), is that the noninvasive vascular laboratory is virtually useless in predicting the success of forefoot amputations in diabetics.
Scrutiny of Table 1 (systolic pressure results) shows that classification of patients according to whether measurements were sequential, nonsequential, or "falsely high" (> 200 mm Hg) is just not significantly related to whether the forefoot amputation healed or failed to heal (χ2 = 4.79; df, 2, not significant [NS]). Classification by ankle systolic pressure seems even less related to outcome (χ2 = 2.27; df, 2, NS). In the group of failed amputees with ankle systolic pressures less than 70 mm Hg in Table 1, I presume there were actually three patients, or 27% of 11 total; not four as given.
BRYANT RC. Forefoot Amputation. Arch Surg. 1980;115(7):889. doi:10.1001/archsurg.1980.01380070075018