The geriatric amputee.

1 Chief, Orthopaedic Service, Veterans Administration Center, Wilshire and Sawtelle Blvds., Los Angeles, Calif. 90073. The geriatric amputee not infrequently suffers from debilitating diseases other than the one which caused his amputation. These affect his prognosis for life, for retention of his other leg, his ability to use a prosthesis, the performance of activities of daily living, his participation in social affairs, his ability to work, and often his finances. Does the elderly amputee live as long as a nonamputee of similar age? Do diabetic amputees die sooner, do they lose the opposite extremity more often, than nondiabetics? Which amputees will use a prosthesis? To answer these and other related questions the Amputee Clinic Teams of the Los Angeles County General Hospital and the Veterans Administration Hospital reviewed 1,770 geriatric patients who, during a ten-year period, became lowerextremity amputees at or above the ankle. We have more recently studied 110 patients who were initially ambulated on preparatory prostheses at the Veterans Administration Hospital. From these studies criteria for probable successful performance on an artificial leg have been derived. Also evolving from these criteria are the procedure employed in the selection of amputees for prosthetic prescription, the training program followed by the Los Angeles Veterans Administration Hospital Amputee Clinic Team, and the development of a special type of prosthesis for a small but worrisome group of patient?. The combined County and Veterans Hospital study disclosed that the geriatric amputee is more likely to die during the year immediately following his amputation than his nonamputee counterpart (Fig. 1). At the end of a year 94 per cent of the otherwise-comparable general population were living, while only 67 per cent of the VA patients and 55 per cent of the County patients had survived. However, if the amputee does not succumb during the initial critical year, he has essentially the same probability of survival as the nonamputee.