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October 7, 1950


Author Affiliations

New York

From the Surgical Division, Montefiore Hospital, New York.

JAMA. 1950;144(6):454-458. doi:10.1001/jama.1950.02920060016005

The results of midleg amputations in a series of 127 cases of gangrene in patients with diabetes were reported by one of us (S. S.) in 1948.1 It was stressed in that report that amputations at the midleg level were preferred to thigh amputations because of lower mortality, better function and lessened tendency to persistent stump pain. Since then a change in technic has been adopted. While almost all the patients with operation up to 1945 were treated by guillotine amputations without skin closure, allowing healing by granulation of the stump, almost all amputations since that date have been closed, and in the majority of patients healing has taken place by primary union. This has resulted in a striking reduction in mortality and a considerable saving of time. We report herein the results of this improved procedure and summarize the data on the entire group of cases up to