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Criteria for determining the proper level of amputation in occlusive vascular disease.

Experience with amputation in occlusive vascular disease at the Mayo Clinic for a five-year period indicates that the history of onset, the physical findings, and the ulimate prognosis should all be taken into account before one embarks on a conservative amputation. When there is a good change of rehabilitation of the patient, one may be justified in doing an amputation below the knee in less than ideal eircumstances. The fact that thirteen of twenty-two patients who had serious wound complications were able to use prostheses supports this viewpoint; in only two of these twenty-two patients was the stump incapable of supporting a prosthesis because of instability of the stump. Toe amputation can be expected to be successful only in thromboangiitis obliterans and in selected diabetic lesions. Use of a prosthesis does not unduly jeopardize the other leg.