Amputation for peripheral vascular disease in the paraplegic and tetraplegic

The occurrence of lower limb gangrene due to atherosclerosis is reported in 14 spinal cord paralysed patients. A further three patients became paraplegic and developed lower limb gangrene following aortic surgery for atherosclerotic complications. The clinical features are described and the difficulty in diagnosing ischaemia in the paralysed limb is emphasised. The incidence and prognosis following amputation are similar to those in the general population and there is no evidence from this series that paraplegia and tetraplegia predispose to atherosclerosis.