What is the role of preprocedural planning in lower-extremity amputations?

Updated: Apr 29, 2021
  • Author: Janos P Ertl, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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An optimal residual extremity is covered with well-vascularized muscle, fascia, and skin. The skin is the most important tissue for healing of the amputation wound and should be handled with care. Careful assessment and handling of the soft tissues assists in creating a durable residual extremity that can withstand friction within the prosthesis. This allows a maximal limb-prosthesis interface that results in greater surface area for a force/stress distribution capable of end weightbearing.

The appropriate level must be planned preoperatively, with acknowledgment of the possibility that a more proximal level may be appropriate and that leaving the wound open for a staged procedure may also be appropriate. Decisions and adjustments are made on an intraoperative basis and planned for preoperatively. The options and possibilities are presented to the patient and family during the informed consent discussion.

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