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Amputation

Pending leg amputation

07/22/2008

Question:

I`m a 56 year old woman with circulation problems in my left leg. My doctor is recomending my left leg be amputated just below the knee very soon. I already lost my right leg about a foot above my knee two years ago. They first amputated the right leg at the knee and then two months later about a foot higher. My stump is very short, less than six inches. I told my doctor that I wanted him to go ahead and amputate my left leg about a foot above my knee, like the right one was done the second time so I wouldn`t need to possibly go through it another time. I already use a wheelchair all the time, this won`t change. My doctor doesn`t really want to take my left leg that high, at least not right now. The doctor wants to amputate in the next two weeks. I need some advice. I feel I`m better off just amputating the left leg a foot above my knee like the right one is now. I feel it would be easier for me to move around if they were the same. I haven`t had any problems with the right leg since the second surgery. I figure it should be my choice since it`s my leg. My left leg will be coming off no later than August 4th. the surgery has been scheduled. It maybe sooner. I just don`t know exactly where yet. What is your opinion on where my left leg should be amputated?

Answer:

If your surgeon is confident your healing would progress smoothly if you undergo an amputation below the knee, usually it is best to save the knee, since leaving the knee intact - not only so it can continue to bend and straighten, but to also leave a longer residual limb to serve as a more effective lever - usually benefits certain aspects of a person's mobility, particularly when attempting to turn or otherwise move from a lying down position, even if they have no plans to use a prosthesis. However, amputation below the knee requires the person to perform a regular exercise program for their residual limb, particularly to counteract the tendency to develop a "knee flexion contracture", which is if the back of the knee becomes too tight to allow the person to fully straighten their knee.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University