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December 1968

Below Knee Amputation for Vascular Insufficiency: Experience With Immediate Postoperative Fitting of Prosthesis

Author Affiliations

San Francisco
From the Surgical Services, Veterans Administration Hospital and University of California School of Medicine, San Francisco.

Arch Surg. 1968;97(6):886-893. doi:10.1001/archsurg.1968.01340060064006

IMMEDIATE postoperative fitting of prosthesis and early ambulation have been successful in expediting the rehabilitation of patients requiring lower-extremity amputation for orthopedic indications.1-5 Many vascular surgeons now advocate below-knee amputation as the level of choice for irreversible ischemia of the lower extremity. There has been reluctance, however, to apply the immediate fitting technique to patients with vascular disease. This reflects the concern of many that early ambulation might traumatize the stumps of the patients with marginal blood supply and result in the failure of the below-knee amputation. This study was organized to evaluate the applicability of immediate fitting technique to patients undergoing lower-extremity amputation for ischemia. Particular attention was focused on the effect of this procedure on stump healing and prosthetic rehabilitation.

Clinical Material and Methods of Study  From June 1967 to April 1968, twenty consecutive below-knee amputations in twenty patients were performed, followed by immediate postoperative fitting of

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