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Adv Wound Care (New Rochelle). 2013 Feb;2(1):30-35.

The Below-Knee Amputation: To Amputate or Palliate?

Author information

  • Center for Wound Healing, Georgetown University Hospital , Washington, District of Columbia.

Abstract

SIGNIFICANCE:

A below-knee amputation (BKA) can be the most functional option for select patients with a diseased lower extremity and may offer a better quality of life than limb salvage in some patients.

RECENT ADVANCES:

Because of advances in prosthetic technology, some patients may have a better quality of life with a BKA than a salvaged lower extremity. Those who cannot wear a prosthesis will do better with a poorly functioning leg. Understanding which patients will not benefit from an amputation helps ensure that a maximum of patients will continue ambulating.

CRITICAL ISSUES:

We lack a thorough understanding of which patients will be more functional with a BKA than a salvaged extremity. Some will do better with a prosthesis, whereas others will do better with a poorly functioning peg leg. This is because so many amputees never wear their prosthesis.

FUTURE DIRECTIONS:

A better understanding of patient selection and optimal operative technique would allow us to better council patients as to how to optimize their functional outcome. Over the past 30 years, a number of useful studies have been published regarding the BKA. However, recent advances in wound care, prosthetics, and medical care in general require a re-evaluation of the BKA within the limb salvage concept.

PMID:
24527321
[PubMed]
PMCID:
PMC3840477
Free PMC Article

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