Early Management of Elderly Dysvascular Below-Knee Amputees

The majority of transtibial (belowknee) amputations occur in elderly patients with systemic vascular disease. Rehabilitation efforts toward prosthetic ambulation are frequently delayed awaiting postoperative healing of the vascular compromised limb. Rehabilitation becomes more difficult, more costly and less successful the longer it is delayed after surgery, especially among elderly amputees. Early ambulation reduces the risk of complications such as thromboembolism, pneumonia and deconditioning in the older patient as well as enhances remaining life. An early coordinated post-amputation rehabilitation program reduces the time to prosthetic ambulation and the risk of further debility and failure among elderly amputees. The rigid removable dressing was incorporated into the program and found to be a safe method of residual limb shrinkage among elderly dysvascular transtibial amputees.