Lower limb amputation Part 1

Introduction The ambitious consensus conference of ISPO in 1990 summarised what was up till then the scientifically published state of the art regarding amputation of limbs. The conference report included operating methods with different indications and perioperative regimens for all levels and patient categories. Now, to update on surgical knowledge over the last decade, a Medline search by use of Lower limb + Amputation + Surgery yielded 1,729 references with the time limit of 10 years. With limitation to Amputation + Leg + Methods it produced 135 references including English, French and German languages. This focus will be retained perceiving the different circumstances between war areas and non-war areas both in Africa with infections and tumours (Loro and Franceschi, 1999) and in western societies with dysvascular cases accounting for 90% of all amputations and a mean age twice as high. Why is diabetes still a little less than 50% and mean survival only a little more than 2 years (Ebskov, 1999)? Another very interesting observation on diabetics recently was that amputations were four times more common on the right side than the left both in type 1 and in type 2 diabetes and both at partial foot and at trans-tibial levels in a series of 1,876 patients (Coxon and Gallen, 1999).