Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “AMPUTATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 757 records · Page 42Linked to original sources
PubMed2006

Falsely high ankle-brachial index predicts major amputation in critical limb ischemia.

Falsely high ankle-brachial index (ABI) values are associated with an adverse clinical outcome in diabetes mellitus. The aim of the present study was to verify whether such an association also exists in patients with chronic critical limb ischemia (CLI) with and without diabetes. A total of 229 patients (74 +/- 11 years, 136 males, 244 limbs with CLI) were followed for 262 +/- 136 days. Incompressibility of lower limb arteries (ABI > 1.3) was found in 45 patients, and was associated with diabetes mellitus (p = 0.01) and renal insufficiency (p = 0.035). Limbs with incompressible ankle arteries had a higher rate of major amputation (p = 0.002 by log-rank). This association was confirmed by multivariate Cox regression analysis (relative risk [RR] 2.67; 95% CI 1.27-5.64, p = 0.01). The relationship between ABI > 1.3 and amputation rate persisted after subjects with diabetes and renal insufficiency had been removed from the analysis (RR 3.85; 95% CI 1.25-11.79, p = 0.018). Dividing limbs with measurable ankle pressure according to tertiles of ABI, the group in the second tertile (0.323 < or = ABI < or = 0.469) had the lowest amputation rate (4/64, 6.2%), and a U-shaped association between the occurrence of major amputation and ABI was evident. No association was found between ABI and mortality. In conclusion, this study demonstrates that falsely high ABI is an independent predictor of major amputation in patients with CLI.

Aged↗
PubMed1988

Motor activity in the stump of an amputated leg during free walking in cockroaches.

1. A rhythmic pattern of motor activity was recorded in the stump of an amputated leg during free walking in cockroaches. 2. During relatively rapid walking, extensor (depressor) and flexor (elevator) muscles in the intact coxa of the amputated leg showed one burst of activity during each cycle of bursting in an adjacent, intact leg. However, during slower walking these muscles could show two or three bursts of activity during each cycle of bursting in an intact leg. 3. Motor bursts in the stump of an amputated leg showed features similar to those of bursts recorded from intact legs. Burst duration increased with an increase in period, and the bursts generally showed consistent timing (phase) relative to bursts in most of the intact legs. 4. The motor pattern recorded in a stump was very like that recorded in an intact leg during walking, and unlike that recorded during searching for a foothold (defined in the text). It is concluded that after the amputation of most of a leg, motor neurones innervating muscles in the stump of the amputated leg continue to be driven by the interneurones that normally drive the intact leg during walking. Analysis of the motor pattern in the stump may therefore reveal important features of the locomotor control system.

Amputation Stumps↗
PubMed1991

Perturbation of the motor system in freely walking cockroaches. II. The timing of motor activity in leg muscles after amputation of a middle leg.

1. The effects of amputation of a middle leg on the motor pattern in the legs of freely walking cockroaches (Periplaneta americana L.) were studied. 2. The general effects of amputating a middle leg are similar to those arising from amputation of a rear leg. These effects are: multiple bursting, more variable and inconsistent timing (phase) between bursts and a tendency for timing effects to appear only during relatively slow walking. 3. The phase of bursts in the amputated stump relative to bursts in the leg in front of it was speed-dependent. However, the phase of stump bursts relative to bursts in the legs across from and behind the stump were not especially dependent on the speed of walking. In general, the phases of bursts in most leg pairs seemed relatively little affected by the amputation except for an increase in scatter. 4. It is concluded that loss of a middle leg disrupts the motor pattern less severely than does loss of a rear leg. The implications of this and other results for the understanding of motor control are discussed.

Amputation, Surgical↗
PubMed2005

Isolated limb perfusion with tumor necrosis factor and melphalan prevents amputation in patients with multiple sarcomas in arm or leg.

BACKGROUND: Treatment for extremity soft tissue sarcoma (STS) has shifted in recent years from amputation to local wide excision combined with irradiation. For multiple sarcomas, this limb-sparing approach is often not possible. To avoid amputations, isolated limb perfusion (ILP) with tumor necrosis factor and melphalan is an attractive treatment option for patients with multiple extremity sarcomas. METHODS: We investigated a prospective database at a tertiary referral institute. From July 1991 to July 2003, out of 217 ILPs, 64 ILPs were performed for either multifocal primary sarcomas or multiple sarcoma recurrences in 53 patients. All ILPs were performed under mild hyperthermic conditions by using 1 to 4 mg of tumor necrosis factor and 10 to 13 mg/L of limb volume for leg and arm perfusions, respectively. RESULTS: The overall response was 88%, with 42% complete response, 45% partial response, 11% no change, and 2% progressive disease. This response rate is significantly better than our experience in 153 locally advanced single-STS cases (88% vs. 69%). The toxicity of the procedure was mild to moderate in almost all cases; no treatment-related amputation had to be performed. The time to local recurrence was 29 months and differed significantly between multiple primary and multiple recurrent STS. The 5-year survival rate was 39%. Limb salvage was achieved in 45 (82%) of 55 treated limbs. CONCLUSIONS: In a group of patients who are uniformly candidates for amputation, ILP can achieve limb salvage in approximately four out of five patients. Because this treatment option provides excellent local control, it should be considered before an amputation is planned.

Adult↗
PubMed2002

Surgical experience and supervision may influence the quality of lower limb amputation.

AIM: Only half of those patients undergoing major lower limb amputations for peripheral vascular disease (PVD) are likely to mobilise on a prosthesis. This study aimed to determine whether a surgeon's experience influenced the quality of the residual limb and thus the likelihood of the stump being suitable for a prosthesis. METHODS: All patients undergoing major lower limb amputations for PVD were recruited prospectively, between August 1992 and July 1996. Following surgery, patients were categorised, by a consultant in rehabilitation medicine, as potentially suitable (group 1) or unsuitable (group II) for rehabilitation. Patients in group I were further assessed by prosthetists for limb fitting. RESULTS: A total of 217 patients underwent 260 amputations for PVD between 1992 and 1996: transfemoral (TFA) 131, trans-tibial (TTA) 127, and through-knee (TKA) in 2. The 30-day mortality was 12% (n = 27). Following surgery, 109 patients were assigned to group I (51%), and 81 patients to group II (37%). The proportion of junior surgeons performing surgery was similar for patients in both groups. Twenty-three amputation stumps (9%) required revision or conversion to a higher level within 30 days. Revisions or conversions were significantly more frequent where the original operation had been performed by an unsupervised junior surgeon rather than a senior surgeon (P = 0.009). The rate of defective amputations compromising limb fitting also reached significance when unsupervised junior and senior surgeons were compared (P = 0.04). CONCLUSIONS: Rehabilitation of the relatively few amputees who reach the stage of limb fitting is hindered by poor surgical technique in a large proportion of cases. Patients operated on by a more experienced surgeon had a better chance of mobilising without revision or conversion surgery.

Adult↗
PubMed2004

[Lower extremity amputations in diabetic patients: a case-control study].

OBJECTIVE: Lower extremity amputation is an increasing problem among diabetic patients and an important public health problem. The study purpose was to identify factors associated with lower extremity amputation. METHODS: A matched case-control study was carried out among diabetic patients. Cases were selected in public health programs of the city of São Paulo, Brazil. One hundred and seventeen cases of diabetics with lower extremity amputation were compared to 234 controls of diabetics without amputation, matched by sex, age, and duration of disease. Sociodemographic variables, life habits (smoking and alcohol drinking), clinical aspects, and health education in diabetes were included. Univariate analyses and conditional logistic regression method were applied to data. RESULTS: Data showed evidence of association for: smoking, last glucose test > or = 200 mg/dl, presence of peripheral somatic neuropathy and vibratory perception (tuning fork 128 Hz), and peripheral vascular disease. Diabetes treatment and attending nursing appointments for diabetes education were important factors for preventing lower extremity amputation in diabetic patients. CONCLUSIONS: The knowledge of determinants and intervening factors for this condition will lead to cost reduction and better quality of care delivered in public health services.

Aged↗
PubMed2001

Capture-recapture method to estimate lower extremity amputation rates in Rio de Janeiro, Brazil.

OBJECTIVE: To estimate rates of lower extremity amputations (LEAs) in persons with peripheral vascular disease, diabetes mellitus, trauma, neoplasm, osteomyelitis, or emphysematous gangrene. METHODS: Regional amputee registries were used to estimate the rate of lower extremity amputations with the capture-recapture (CR) technique. Data were extracted from three amputee registries in Rio de Janeiro: source 1, with 1,191 cases from 23 hospitals; source 2, with 157 cases from a limb-fitting center; and source 3, with 34 cases from a rehabilitation center. Amputee death certificates from source 1 identified 257 deaths from 1992 to 1994. Three CR models were evaluated using sources 2 and 3. In order to avoid an overestimation of the rate of LEAs, two models were applied for the data analysis: in one case, deceased patients listed in source 1 were excluded from the model, and in the other case, deceased patients were included as well. RESULTS: Excluding the 257 deaths, the estimated number of amputations in the municipality of Rio de Janeiro from 1992 to 1994 was 3,954, for a mean annual incidence rate of 13.9 per 100,000 inhabitants. Among persons with diabetes, the annual incidence rate of lower extremity amputations was substantially higher (180.6 per 100,000 persons per year), representing 13 times the risk of individuals without diabetes. The yearly rate of LEAs according to the routine surveillance system was estimated at 5.4 and 96.9 per 100,000 in the general population and in diabetics, respectively. If data from the three registries are added, 1,382 patients with LEAs were identified, with the reasons for the amputations distributed as follows: peripheral vascular disease = 804 (58.1%); diabetes mellitus = 379 (27.4%); trauma = 103 (7.4%); osteomyelitis = 44 (3.1%); gangrene = 36 (2.6%), and neoplasm = 16 (1.1%). CONCLUSIONS: These findings show a high incidence of LEAs in Brazil, when compared to countries such as Spain, that is attributable mainly to peripheral vascular disease and diabetes mellitus.

Amputation, Surgical↗
PubMed2003

[Satisfaction with life overall and with specific life domains among elderly persons with a lower limb amputation].

OBJECTIVE: To examine a group of elderly persons who had had a lower limb amputation and who were receiving care at the outpatient clinic of a teaching hospital in Campinas, São Paulo, Brazil, in order to: 1) identify relationships between their perceived overall life satisfaction and their functional capacity; 2) assess their perceived satisfaction with the domains of health, physical functioning/dependence, mental health, and social integration/involvement; and 3) identify relationships between overall life satisfaction and satisfaction with the specific domains. METHODS: An assessment was done of a group of 40 elderly persons (30 men and 10 women) who had had an amputation above the malleolus at least 1 year earlier and who were undergoing rehabilitation between June 1994 and June 1999. Their mean age was 74.5 years (range, 60 to 79 years). A questionnaire was used for data collection to assess: 1) functional capacity (Barthel index); 2) general life satisfaction (Cantrill model); and 3) satisfaction with the domains of health, physical functioning/dependence, mental health, and social integration/involvement, with the 40 elderly persons assessing themselves both in individual terms and in comparison to other persons of the same age group. RESULTS: Among the 40 elderly persons, the level of general life satisfaction was high. Measured on a scale of 1 to 10, the mean was 7.1 and the median 7.5, with a standard deviation of 2.73. There was no correlation between overall life satisfaction and functional capacity. There was no significant difference between individual perceived satisfaction with the specific domains and the perception of these domains in comparison to other persons of the same age group; in both of these cases, the elderly persons who had had an amputation reported a high degree of satisfaction. A positive correlation was found only between overall life satisfaction and the domains of health (individual and comparative) and of physical functioning (comparative). CONCLUSIONS: These results suggest that this group of elderly persons who had had an amputation tended to assess their situation positively. This finding provides new insights into the rehabilitation of elderly persons with lower limb amputations. Taken together with the dearth of studies concerning the subject, this finding also indicates the need for additional research focusing on the subjective well-being of the elderly.

Aged↗
PubMed1995

Proximal femoral focal deficiency: results of rotationplasty and Syme amputation.

We reviewed the results of treatment of sixteen patients who had had an isolated unilateral proximal femoral focal deficiency; nine were managed with a rotationplasty and seven, with a Syme amputation combined with an arthrodesis of the knee. We evaluated the perceived physical appearance, gross motor function, and metabolic energy expended in walking. The mean duration of follow-up was 9.9 years (range, four to fourteen years). The mean age of the patients at the time of the study was 13.9 years (range, eight to 18.4 years) in the rotationplasty group and 14.8 years (range, 9.5 to 19.9 years) in the Syme-amputation group. There were three female patients in each group. Roentgenograms showed that the femoral head was in the acetabulum (Aitken class A or B) in four of the seven patients in the Syme-amputation group and in five of the nine patients in the rotationplasty group; the remaining patients did not have this finding (Aitken class C or D). There was no difference in gross motor function or perceived physical appearance between the groups. Rotationplasty was associated with a more energy-efficient gait (mean, 0.153 milliliter of oxygen per kilogram-meter [range, 0.128 to 0.173 milliliter of oxygen per kilogram-meter] than was Syme amputation (mean, 0.169 milliliter of oxygen per kilogram-meter [range, 0.151 to 0.182 milliliter of oxygen per kilogram-meter]). Both types of treatment resulted in a net oxygen utilization per distance (efficiency) that was less than the values reported after amputations performed for non-congenital disorders.

Activities of Daily Living↗
PubMed1999

Factors associated with bone regrowth following diabetes-related partial amputation of the foot.

BACKGROUND: The formation of hypertrophic bone after partial resection of metatarsal bone has the potential to cause abnormal foci of high pressure in people who have diabetes mellitus; this may increase the risk of reulceration and reamputation. However, we are not aware of previous studies evaluating the risk factors for this entity. METHODS: The records of ninety-two adults (mean age, 54+/-10.1 years; range, thirty to seventy-four years) with diabetes who had had an isolated partial amputation of a ray were abstracted. Repeat radiographs were made for all of these subjects at a mean of 22+/-6.1 months (range, thirteen to thirty-five months) after the initial procedure. The formation of hypertrophic bone was defined as more than three millimeters of regrowth. RESULTS: A total of forty-one (45 percent) of the subjects had formation of hypertrophic bone at the time of radiographic analysis after isolated partial amputation of a ray. On multivariate analysis, the factors that were significantly associated with this regrowth of bone were male gender (88 percent [thirty-six] of the forty-one patients who had bone regrowth were male compared with 51 percent [twenty-six] of the fifty-one patients who did not have bone regrowth; p<0.01, odds ratio = 5.7, 95 percent confidence interval = 1.8 to 18.9), the use of manual bone-cutting instruments (used in 56 percent [twenty-three] of the forty-one patients who had bone regrowth compared with 16 percent [eight] of the fifty-one who did not; p<0.01, odds ratio = 4.7, 95 percent confidence interval = 1.6 to 13.8), and a resection made distal to the surgical neck of the metatarsal (used in 34 percent [fourteen] of the forty-one patients who had bone regrowth compared with 12 percent [six] of the fifty-one who did not; p<0.03, odds ratio = 4.5, 95 percent confidence interval = 1.2 to 16.9). The patients who had regrowth of bone were approximately eight times more likely to have reulceration at the site of the amputation than were those who did not have regrowth (24 percent [ten] of the patients with regrowth had reulceration compared with 4 percent [two] of the patients without regrowth; p<0.01, chi square = 8.4, odds ratio = 7.9, 95 percent confidence interval = 1.6 to 38.5). CONCLUSIONS: Overgrowth of the bone of a transected metatarsal predisposes patients to ulceration. Male gender, the use of manual bone-cutting instruments, and metaphyseal amputation may be associated with long-term regrowth of bone following isolated partial amputation of a ray. The use of power instruments during these procedures may lead to a lower prevalence of this reaction, thereby potentially reducing the risk of ulceration, infection, and reamputation.

Adult↗
PubMed1995

Risk factors for lower extremity amputation in persons with diabetes.

OBJECTIVE: To determine the predictors of lower extremity amputation (LEA) in a cohort of persons with diabetes (primarily non-insulin-dependent). RESEARCH DESIGN AND METHODS: We conducted a nested case-control study among 10,068 patients from a large health maintenance organization who reported a diagnosis of diabetes at a multiphasic health checkup (MHC) (baseline) between 1964 and 1984. Average length of follow-up after baseline was 13.2 years. Case patients were 150 cohort members with a first, nontraumatic LEA after baseline. Control subjects were 278 cohort members who did not experience an LEA during follow-up, matched to patients on age, sex, and year of baseline MHC. The presence of diabetes at baseline was verified by chart review for both patients and control subjects. Cardiovascular disease risk factors were obtained at the baseline MHC; glucose control, other diabetes-related variables, preventive services, and other complications were obtained from chart review. RESULTS: Level of glucose control (P < 0.0001), duration of diabetes (P = 0.04), and baseline systolic blood pressure (P = 0.004) were independent predictors of amputation, as were microvascular complications (retinopathy, neuropathy, and nephropathy). History of stroke, but not myocardial infarction, was also independently predictive; type of diabetes, cigarette smoking, and total cholesterol level were not. Being African-American was unrelated to amputation risk in univariate or multivariate analyses in this insured population. CONCLUSIONS: LEA shares a risk factor profile with other microvascular complication of diabetes. Thus, control of blood glucose and blood pressure should reduce risk for amputation. African-Americans do not appear to be at increased risk for diabetes-related amputation when access to medical care is comparable.

Black or African American↗
PubMed1998

Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation.

OBJECTIVE: To validate a wound classification instrument that includes assessment of depth, infection, and ischemia based on the eventual outcome of the wound. RESEARCH DESIGN AND METHODS: We evaluated the medical records of 360 diabetic patients presenting for care of foot wounds at a multidisciplinary tertiary care foot clinic. As per protocol, all patients had a standardized evaluation to assess wound depth, sensory neuropathy, vascular insufficiency, and infection. Patients were assessed at 6 months after their initial evaluation to see whether an amputation had been performed. RESULTS: There was a significant overall trend toward increased prevalence of amputations as wounds increased in both depth (chi 2trend = 143.1, P < 0.001) and stage (chi 2trend = 91.0, P < 0.001). This was true for every subcategory as well with the exception of noninfected, nonischemic ulcers. There were no amputations performed within this stage during the follow-up period. Patients were more than 11 times more likely to receive a midfoot or higher level amputation if their wound probed to bone (18.3 vs. 2.0%, P < 0.001, chi 2 = 31.5, odds ratio (OR) = 11.1, CI = 4.0-30.3). Patients with infection and ischemia were nearly 90 times more likely to receive a midfoot or higher amputation compared with patients in less advanced wound stages (76.5 vs. 3.5%, P < 0.001, chi 2 = 133.5, OR = 89.6, CI = 25-316). CONCLUSIONS: Outcomes deteriorated with increasing grade and stage of wounds when measured using the University of Texas Wound Classification System.

Adult↗
PubMed2001

New ulceration, new major amputation, and survival rates in diabetic subjects hospitalized for foot ulceration from 1990 to 1993: a 6.5-year follow-up.

OBJECTIVE: To evaluate 1) the new ulceration, the new major amputation, and the survival rates of 115 diabetic subjects hospitalized for foot ulceration from 1990 to 1993, with an average follow-up of 6.5 years, and 2) the demographic and clinical characteristics associated with these events. RESEARCH DESIGN AND METHODS: A total of 115 subjects, 31 women and 84 men, were monitored until 31 December 1998. All subjects were provided with therapeutic shoes and received intense education. Data concerning new ulceration, new major amputation, and reamputation events and the date and cause of death were recorded for each patient. The prognostic factors for these events were then evaluated. RESULTS: The average follow-up was 78.3 +/- 15.3 months (range 60-106). During this time, 13 homolateral and 12 contralateral episodes of new ulceration occurred. At univariate analysis, none of the variables considered were significantly associated with the new ulceration. There were three major amputations: two of the limb previously healed and one of the contralateral limb. Of the 115 subjects, 51 (44.3%) died: 24 of the 31 women (77.4%) and 27 of the 84 men (32.1%). Ischemic cardiopathy was the most frequent cause of death (60.8%). Mortality concerned 20 of the 27 subjects (74.1%) undergoing major amputation from 1990 to 1993 and 31 of the 88 healed subjects (35.2%), with a significant difference (P < 0.0001). Multivariate analysis showed the independent role of the ankle-brachial index < or =0.5 (P = 0.005), age (P = 0.003), and female sex (P = 0.027). CONCLUSIONS: We believe that the use of therapeutic shoes and intense educational training, including the education of the family, have contributed to the low incidence of new ulceration and major amputation in our study population. The high frequency of ischemic cardiopathy as a cause of death should, perhaps, lead to a more aggressive diagnostic and therapeutic attitude toward this pathology in diabetic subjects admitted to hospitals for foot ulceration.

Age Factors↗
PubMed2004

Incidence of lower-extremity amputation in American Indians: the Strong Heart Study.

OBJECTIVE: To define incidence and predictors of nontraumatic lower-extremity amputation (LEA) in a diverse cohort of American Indians with diabetes. RESEARCH DESIGN AND METHODS: The Strong Heart Study is a study of cardiovascular disease and its risk factors in 13 American-Indian communities. Data on the presence/absence of amputations were collected at each of three serial examinations (1989-1992, 1993-1995, and 1997-1999) by direct examination of the lower extremity. The logistic regression model was used to quantify the relationship between risk of LEA and potential risk factors, including diabetes duration, HbA(1c), peripheral arterial disease, and renal function. RESULTS: Of the 1,974 individuals with diabetes and without prevalent LEA at baseline, 87 (4.4%) experienced an LEA during 8 years of follow-up, and a total of 157 anatomical sites were amputated among these individuals. Amputation of toes was most common, followed by below-the-knee and above-the-knee amputations. Age-adjusted odds of LEA were higher among individuals with unfavorable combinations of risk factors, such as albuminuria and elevated HbA(1c). Multivariable modeling indicated that male sex, renal dysfunction, high ankle-brachial index, longer duration of diabetes, less than a high school education, increasing systolic blood pressure, and HbA(1c) predicted LEA risk. CONCLUSIONS: The 8-year cumulative incidence of LEA in American Indians with diabetes is 4.4%, with marked differences in risk by sex, educational attainment, renal function, and glycemic control.

Amputation, Surgical↗
PubMedDate not supplied

Veterans Administration Cooperative Study on antiplatelet agents in diabetic patients after amputation for gangrene: II. Effects of aspirin and dipyridamole on atherosclerotic vascular disease rates.

We report the results of a randomized multicenter clinical trial on the effects of aspirin plus dipyridamole versus placebo on major vascular end points in 231 non-insulin-dependent diabetic men with either a recent amputation for gangrene or active gangrene. Primary end points were death from atherosclerotic vascular disease plus amputation of the opposite extremity for gangrene. There were 24 atherosclerotic deaths in the drug treatment group (21.8%) and 23 in the placebo group (19.0%). There were 22 patients in the drug treatment group (20.0%) and 29 patients in the placebo group (24.0%) with opposite-side amputations. Survival curve analyses revealed little difference between these groups for major vascular end points, total mortality, all amputations, or myocardial infarctions. The most noteworthy group difference was observed for cerebrovascular end points (strokes and transient ischemic attacks), with an incidence of 8.2% (9 patients) in the drug treatment group and 19.0% (23 patients) in the placebo group. We conclude from this study that antiplatelet agents have no effect on the primary vascular end points, vascular deaths and/or amputation of the opposite extremity, in this population. Similarly, no effects were seen on secondary vascular end points, except for a suggestion of protection versus strokes and transient ischemic attacks. However, this finding must be interpreted with caution, since it is a secondary end point and was found only after multiple analyses of the data.

Amputation, Surgical↗
PubMed1988

Traumatic amputation of the upper limb: the use of body-powered prostheses and employment consequences.

Forty three patients with unilateral traumatic amputations were reviewed as to the use of prostheses and employment consequences of the amputation. Seventeen of 19 below-elbow amputees, and 12 of 24 above-elbow amputees used their prostheses. Non-users compared to users of prostheses were characterized by: 1) Higher level of amputation 2) Non-dominant arm amputation and 3) Younger age at the time of amputation. However non-users usually did well on the labour market for various reasons.

Adult↗
PubMed1983

Selection of amputation level. Comparison between morphine puncture test and skin perfusion pressure.

In 46 amputations performed on account of peripheral occlusive arterial disease, the morphine puncture test (MPT) and the local skin perfusion pressure measurement (SPP) were carried out preoperatively. Below-knee (BK) amputation was performed when the SPP was greater than or equal to 40 mm Hg unless clinical criteria indicated otherwise. Out of 12 BK amputations without any clinical skin changes, where the SPP was greater than or equal to 40 mm Hg but the MPT was negative, healing was achieved in 11 patients. Thus, if the MPT had been used as an objective method to determine the amputation level, 11 knees would have been sacrificed. The MPT is thus not suitable for determination of amputation level in patients with peripheral occlusive arterial disease.

Adult↗
PubMedDate not supplied

Care of the elderly patient with lower extremity amputation.

BACKGROUND: The elderly patient with a lower extremity amputation (LEA) remains relatively common in most family medicine practices. LEA can be categorized into three major types: partial foot, transtibial amputation, and transfemoral amputation. Family physicians have not been well trained to provide care to these patients. METHODS: A literature review was performed using the key words "lower extremity amputation," "aged" and "rehabilitation." RESULTS AND CONCLUSIONS: Appropriate medical, surgical, and rehabilitative care can have a positive effect on the functional outcome for an elderly patient with a lower extremity amputation. The family physician can be instrumental in preparing the patient and family for surgery, providing psychological support, preventing and treating complications, managing comorbid illness, and assisting in rehabilitation. In addition, the family physician is primarily responsible for the daily care needs of these patients.

Age Factors↗