Midcalf Amputation in the Ischemic Extremity

WHEN AN amputation is necessary, rehabilitation can be more frequent and successful with a midcalf than with a supracondylar amputation. Many advantages are available to the patient with a below-theknee amputation.5He can more readily turn in bed, support himself on the knee, and control his prosthesis. The older patient will frequently use a below-knee prosthesis, whereas an above-knee prosthesis is often impractical and is discarded. Blood supply is better and healing is more certain with the thick medial and lateral flap. Careful selection4,8of the patient for the midcalf amputation and utilization of methods to increase the chances of primary healing would seem to minimize failure.1,6 Fifteen patients out of 20 requiring leg amputations were selected for amputation in the midcalf. Medial and lateral flaps were used in all amputations at this level. A 100% healing was obtained including delayed healing in three cases. No deaths