Sixty inpatients with diabetic foot were studied prospectively at the Orthopaedic wards of Hospital Kuala Lumpur. Data was evaluated to document the patient profile and the factors that were associated with a major amputation (either above knee or below knee) of the lower limb. Factors that were associated with increased risk of amputation were a low education level, manual occupation, poor foo...

The Dundee Limb Fitting Centre has provided an integrated rehabilitation programme for the amputee since 1965. A review of 1846 primary amputees is discussed. During this period a dramatic change in the above-knee/below-knee (AK/BK) ratio has been achieved with 71% BK and 26% AK occurring in 1989. Over 80% of all amputees, the majority being elderly with peripheral vascular disease, were succes...

Background A 71 year old, weighing 80 kg was referred to the Foot Wound Clinic despite not having feet. The patient had suffered a traumatic Above Knee Amputation of the right limb and an Above Knee Amputation of the left limb from the same incident in 1969. The patient ambulates on “all fours” or upon the femurs alone and continues to work full-time as a landscaper. The patient presented for r...

Background. The purpose of this article is to present the problems encountered in treatment and rehabilitation, including prosthesis fitting, in the case of a 17-year-old female patient who underwent a bilateral leg amputation using Syme's method. Case history. The patient incurred crushing injuries of both feet and the knee joints, resulting from a severe multi-organ injury. As a result of pos...

There is considerable divergence of opinion about the merits of Syme’s amputation. In some countries it is highly regarded ; in some it is neglected ; in others it even is roundly condemned. In Canada it is thought to be the best of all amputations of the lower extremity above the foot and has been used with consistent success since before the 1914-1918 war to the present day. Experience in Gre...

The problems encountered in fitting and using the permanent below-knee prosthesis in developing countries are the high price of the prosthesis, inadequate fitting and lack of proper rehabilitation. In Turkey, the preferred treatment of the stump post-operatively is by the soft dressing method with bandaging for maturation and shrinkage. Generally, the application of the permanent prosthesis is ...

Skin cover after below-knee amputation has been extensively discussed. We describe the flaps which are commonly used and discuss their vascular basis in the context of the current knowledge of the fasciocutaneous system. An understanding of this vascular system will enable surgeons to plan and shape flaps for surgical exposure and coverage.

Abstract Introduction To identify the preoperative factors that influence functional rehabilitation after Major Lower Limb (MLL) amputation. Method This retrospective study analyzed all patients referred post-amputation to an amputee centre over a period of 1 year. The level outcome at 6 and 12 months were recorded using SIGAM (Special Interest Group in Amputee Medicine) grading. Data on variou...

Knee arthrodesis is an alternative to amputation for treating recalcitrant septic non-union of the proximal tibia with bone loss, soft-tissue compromise, and knee-joint involvement. Nonetheless, arthrodesis is difficult to achieve if bone loss is massive, and the septic environment can result in failed bone fusion. We report on a 77-year-old man with massive bone loss secondary to recalcitrant ...