Lower extremity amputations: a 5-year review and comparative study.

In order to review major lower extremity amputations at the Toronto East General and Orthopaedic Hospital Inc. between 1979 and 1984, 60 patients with 42 below-knee, 17 mid-thigh and 20 Callander through-knee amputations were studied retrospectively. The three amputation groups demonstrated comparable rates of stump healing. A previous history of vascular surgery on the extremity increased the risk for both delayed healing and failure to heal. The Callander through-knee amputees were rehabilitated earlier and more easily than were the mid-thigh amputees, and once rehabilitated they were more likely to continue using their prostheses. The authors recommend that, when possible, the chosen site of amputation for the majority of patients should be below the knee, but when this is not practical a through-knee amputation should be done in preference to a mid-thigh amputation.