[Longitudinal study of vascular patients with standardized Brückner distal limb amputation]

The present study aims to evaluate early and late results after standardized below-knee amputation according to Brückner in vascular patients.

During the period 1982 to 1989 72 patients with occlusive arterial disease stage IV underwent below-knee amputation at an average age of 69.7 years. 38 of the amputees could be re-investigated at the end of 1991 after an average follow-up of 5.3 years. Evaluation criteria consisted of wound healing, knee joint preservation, prosthetic fitting, stump appearance, gait capacity or ambulation, the need for assistance by another person and patients own valuation. Accordingly, rehabilitation level was classified to be good, satisfying or dissatisfying.

Knee joint preservation rate amounted to 91.7% (66 patients). Postsurgical prosthetic fitting could be achieved in 55 amputees (76.4%). All the 38 re-investigated stumps were inapparent. 27 of the patients (71.1%) showed good and 7 patients (18.4%) satisfying rehabilitation, whereas the rehabilitation level was dissatisfying in 4 cases (10.5%). This objective evaluation was affirmed by patients own estimation: 33 amputees (86.6%) would again agree to the operation.

Early as well as late results in this series indicate that the standardized below-knee amputation according to Brückner promises high rates of healing, knee joint preservation and thus successful rehabilitation in patients with occlusive arterial disease.