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Related Experiment Videos

Major amputations: clinical patterns and predictors.

J Dormandy1, L Heeck, S Vig

  • 1Department of Vascular Surgery, St George's Hospital Medical School, London, England, United Kingdom.

Seminars in Vascular Surgery
|April 25, 2000
PubMed
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Major lower limb amputations, particularly in diabetic patients, are common. Below-knee amputations offer better mobility than above-knee, but healing rates and long-term outcomes require careful consideration.

Area of Science:

  • Vascular Surgery
  • Diabetic Complications
  • Limb Salvage

Background:

  • Critical leg ischemia (CLI) leads to major amputations at rates of 200-500/million/year.
  • Diabetic patients constitute a disproportionately high percentage (40-45%) of all amputees.
  • The below-knee (BK) to above-knee (AK) amputation ratio often falls below the recommended 2.5 minimum.

Purpose of the Study:

  • To analyze the outcomes of major lower limb amputations, focusing on healing rates, reamputation, and functional mobility.
  • To evaluate the impact of amputation level (BK vs. AK) on patient prognosis.
  • To identify factors influencing amputation success and long-term survival.

Main Methods:

  • Retrospective analysis of major lower limb amputation data.

Related Experiment Videos

  • Comparison of healing rates and reamputation rates for BK and AK amputations.
  • Assessment of functional mobility and survival at two years post-amputation.

    • Main Results:

    • Primary healing rates for BK amputations range from 30% to 92%, with reamputation rates between 4% and 30%.
    • Palpable popliteal pulse correlates with a low (10%) failure rate for BK amputations.
    • BK amputees achieve significantly better mobility (2-3 times) than AK amputees.
    • Two years post-BK amputation, 15% require conversion to AK, 15% undergo contralateral amputation, and 30% die.

    Conclusions:

    • Amputation level significantly impacts functional outcomes and long-term survival.
    • While BK amputations offer better mobility, careful patient selection and management are crucial for successful healing.
    • High rates of reamputation and mortality highlight the severity of CLI, especially in diabetic patients.