Gangrene of the upper extremity in diabetic patients

Twenty-two patients who had diabetes mellitus and had needed an amputation for gangrene in an upper extremity at an average age of fifty-one years were identified and followed. The five patients who were still living at the latest follow-up had been followed for an average of 50.6 months. The other seventeen patients survived for an average of only 20.6 months after the amputation. All of the patients were in poor health; eighteen had needed an amputation in a lower extremity, and sixteen received hemodialysis. The results of amputation in an upper extremity were unsatisfactory; the site of the initial amputation healed in only two of the twenty-two patients. In the remaining twenty patients, a total of sixty-three additional operations were performed on an upper extremity, and five of the twenty patients died before the wound had healed.