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July 1980

Forefoot Amputation

Author Affiliations

Woodbury, Tenn

Arch Surg. 1980;115(7):889. doi:10.1001/archsurg.1980.01380070075018

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.

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