Below-Knee Amputations in Patients with Severe Arterial Insufficiency

SURGICAL opinion varies widely as to the advisability of performing below-knee amputations in limbs that exhibit diminished circulation at the level of amputation. It has been shown that below-knee amputations can heal by first intention in patients with severe arterial insufficiency,1 , 2 but failure of healing has been reported in the majority of patients who did not have either a popliteal pulse or calf oscillations.3 At present many surgeons believe that below-knee amputations are contraindicated unless there is good arterial circulation at the level of amputation, as evidenced by the presence of calf oscillations and a palpable popliteal pulse. A recent . . .