[Transgenicular amputation with special reference to partial secondary femoral condyle resection]

During the last five years 54 patients (mean age 69 years) have undergone a unilateral, transgenicular (through-knee) amputation, instead of an impending amputation through the thigh. The indication for surgery was a chronic, or an acute critical ischemia of the leg. In 32 and 22 cases respectively, amputations have been preceded by a multitude of reconstructive measures. Uncomplicated stump healing was observed in 25 of 51 survivors (49%). Disturbances in the wound healing process necessitated further amputation in 26 cases (51%). In 13 of these cases the advantage of the transgenicular amputation could be retained by a partial femoral condylectomy, whereas in the other 13 cases a thigh amputation was inavoidable. Thus, in three out of four of the survivors, a long, strong stump with a good terminal load-carrying capacity could be retained which, when supplied by a prosthesis, led to the recovery of the original walking ability in 90% of these cases.