Amputation of the Lower Limb for Ischaemic Disease--a Study of the Functional Results.

AMPUTATION of a limb is a serious and irrevocable step, to be undertaken only when no other course of action is possible. Despite recent advances in arterial surgery, amputations will continue to be necessary and although there has been recent interest in the Stokes Gritti (Martin and Wickham, 1962) and Through Knee techniques (Gillis, 1961), many surgeons continue to remove the leg at the standard above and below knee sites. Despite the large number of these amputations which are performed and the considerable expenditure which is involved in the provision of artificial limbs, very little information is available as to what proportion of patients utilise their prostheses. Perlow (1962) found that although almost all below-knee amputees learned to walk, only about 30% returned to employment. In aboveknee amputees the corresponding figures were 40% and 10%. In view of the inadequacy of the available information it was decided to survey the lower limb amputations performed at The London Hospital in the period covered by the years 1953 to 1962, with particular reference to the patient's ability to make use of an artificial limb.