Lower-Extremity Amputations Questions & Answers

1. Murdoch G, Wilson AB Jr, eds. Amputation: Surgical Practice and Patient Management. St Louis: Butterworth-Heinemann Medical; 1996.

2. Amputations of the lower extremity. Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia: Elsevier; 2017. Vol 1: 674-85.

3. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil. 2008 Mar. 89 (3):422-9. [QxMD MEDLINE Link].

4. Eardley WG, Taylor DM, Parker PJ. Amputation and the assessment of limb viability: perceptions of two hundred and thirty two orthopaedic trainees. Ann R Coll Surg Engl. 2010 Jul. 92 (5):411-6. [QxMD MEDLINE Link].

5. Higgins TF, Klatt JB, Beals TC. Lower Extremity Assessment Project (LEAP)--the best available evidence on limb-threatening lower extremity trauma. Orthop Clin North Am. 2010 Apr. 41 (2):233-9. [QxMD MEDLINE Link].

6. Waters RL, Perry J, Antonelli D, Hislop H. Energy cost of walking of amputees: the influence of level of amputation. J Bone Joint Surg Am. 1976 Jan. 58 (1):42-6. [QxMD MEDLINE Link]. [Full Text].

7. Matsen SL, Malchow D, Matsen FA 3rd. Correlations with patients' perspectives of the result of lower-extremity amputation. J Bone Joint Surg Am. 2000 Aug. 82 (8):1089-95. [QxMD MEDLINE Link].

8. Pandian G, Kowalske K. Daily functioning of patients with an amputated lower extremity. Clin Orthop Relat Res. 1999 Apr. 361:91-7. [QxMD MEDLINE Link].

9. Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004 Oct 1. 39 (7):885-910. [QxMD MEDLINE Link]. [Full Text].

10. American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003 Dec. 26 (12):3333-41. [QxMD MEDLINE Link]. [Full Text].

11. Carter SA, Tate RB. The value of toe pulse waves in determination of risks for limb amputation and death in patients with peripheral arterial disease and skin ulcers or gangrene. J Vasc Surg. 2001 Apr. 33 (4):708-14. [QxMD MEDLINE Link].

12. Boyko EJ, Monteiro-Soares M, Wheeler SGB. Peripheral arterial disease, foot ulcers, lower extremity amputations, and diabetes. Cowie CC, Casagrande SS, Menke A, et al, eds. Diabetes in America. 3rd ed. Bethesda, MD: National Institutes of Health, NIH Pub No. 17-1468; 2017. Chap 20. [Full Text].

13. Burgess EM, Matsen FA 3rd, Wyss CR, Simmons CW. Segmental transcutaneous measurements of PO2 in patients requiring below-the-knee amputation for peripheral vascular insufficiency. J Bone Joint Surg Am. 1982 Mar. 64 (3):378-82. [QxMD MEDLINE Link]. [Full Text].

14. Gabel J, Jabo B, Patel S, Kiang S, Bianchi C, Chiriano J, et al. Analysis of Patients Undergoing Major Lower Extremity Amputation in the Vascular Quality Initiative. Ann Vasc Surg. 2018 Jan. 46:75-82. [QxMD MEDLINE Link].

15. Wang N, Yang BH, Wang G, Gao Y, Cao X, Zhang XF, et al. A meta-analysis of the relationship between foot local characteristics and major lower extremity amputation in diabetic foot patients. J Cell Biochem. 2019 Jun. 120 (6):9091-9096. [QxMD MEDLINE Link].

16. Yang JY, Wang T, Pate V, Gower EW, Crowley MJ, Buse JB, et al. Sodium-glucose co-transporter-2 inhibitor use and risk of lower-extremity amputation: Evolving questions, evolving answers. Diabetes Obes Metab. 2019 May. 21 (5):1223-1236. [QxMD MEDLINE Link].

17. Erken Pamukcu H, Sunman H, Taş A, Aker M, Şahan HF, Açıkel S. The role of prognostic nutritional index in predicting amputation in patients with lower extremity peripheral artery disease. J Cardiovasc Thorac Res. 2021. 13 (1):43-48. [QxMD MEDLINE Link]. [Full Text].

18. Arya S, Khakharia A, Binney ZO, DeMartino RR, Brewster LP, Goodney PP, et al. Association of Statin Dose With Amputation and Survival in Patients With Peripheral Artery Disease. Circulation. 2018 Apr 3. 137 (14):1435-1446. [QxMD MEDLINE Link].

19. Tintle SM, Forsberg JA, Keeling JJ, Shawen SB, Potter BK. Lower extremity combat-related amputations. J Surg Orthop Adv. 2010 Spring. 19 (1):35-43. [QxMD MEDLINE Link].

20. Parker K, Kirby RL, Adderson J, Thompson K. Ambulation of people with lower-limb amputations: relationship between capacity and performance measures. Arch Phys Med Rehabil. 2010 Apr. 91 (4):543-9. [QxMD MEDLINE Link].

21. Ottaviani G, Robert RS, Huh WW, Jaffe N. Functional, psychosocial and professional outcomes in long-term survivors of lower-extremity osteosarcomas: amputation versus limb salvage. Cancer Treat Res. 2009. 152:421-36. [QxMD MEDLINE Link].

22. Kayssi A, de Mestral C, Forbes TL, Roche-Nagle G. A Canadian population-based description of the indications for lower-extremity amputations and outcomes. Can J Surg. 2016 Apr. 59 (2):99-106. [QxMD MEDLINE Link].

23. Al-Thani H, El-Matbouly M, Al-Sulaiti M, Al-Thani N, Asim M, El-Menyar A. Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?. Curr Vasc Pharmacol. 2019. 17 (4):354-364. [QxMD MEDLINE Link].

24. Ahn J, Raspovic KM, Liu GT, Lavery LA, La Fontaine J, Nakonezny PA, et al. Renal Function as a Predictor of Early Transmetatarsal Amputation Failure. Foot Ankle Spec. 2019 Oct. 12 (5):439-451. [QxMD MEDLINE Link].

25. Norvell DC, Thompson ML, Boyko EJ, Landry G, Littman AJ, Henderson WG, et al. Mortality prediction following non-traumatic amputation of the lower extremity. Br J Surg. 2019 Jun. 106 (7):879-888. [QxMD MEDLINE Link].

26. Hardy DM, Lyden SP. The Majority of Patients Have Diagnostic Evaluation Prior to Major Lower Extremity Amputation. Ann Vasc Surg. 2019 Jul. 58:78-82. [QxMD MEDLINE Link].

27. Wyss CR, Harrington RM, Burgess EM, Matsen FA 3rd. Transcutaneous oxygen tension as a predictor of success after an amputation. J Bone Joint Surg Am. 1988 Feb. 70 (2):203-7. [QxMD MEDLINE Link]. [Full Text].

28. Misuri A, Lucertini G, Nanni A, Viacava A, Belardi P. Predictive value of transcutaneous oximetry for selection of the amputation level. J Cardiovasc Surg (Torino). 2000 Feb. 41 (1):83-7. [QxMD MEDLINE Link].

29. Tseng CH, Chong CK, Tseng CP, Cheng JC, Wong MK, Tai TY. Mortality, causes of death and associated risk factors in a cohort of diabetic patients after lower-extremity amputation: a 6.5-year follow-up study in Taiwan. Atherosclerosis. 2008 Mar. 197 (1):111-7. [QxMD MEDLINE Link].

30. Azouz SM, Castel NA, Vijayasekaran A, Rebecca AM, Lettieri SC. Lower-limb reconstruction with chimeric flaps: The quad flap. Microsurgery. 2019 Feb. 39 (2):182-187. [QxMD MEDLINE Link].

31. Dudkiewicz I, Schwarz O, Heim M, Herman A, Siev-Ner I. Trans-metatarsal amputation in patients with a diabetic foot: reviewing 10 years experience. Foot (Edinb). 2009 Dec. 19 (4):201-4. [QxMD MEDLINE Link].

32. Schmidt BM, McHugh JB, Patel RM, Wrobel JS. Prospective Analysis of Surgical Bone Margins After Partial Foot Amputation in Diabetic Patients Admitted With Moderate to Severe Foot Infections. Foot Ankle Spec. 2019 Apr. 12 (2):131-137. [QxMD MEDLINE Link].

33. Taylor BC, Poka A. Osteomyoplastic Transtibial Amputation: The Ertl Technique. J Am Acad Orthop Surg. 2016 Apr. 24 (4):259-65. [QxMD MEDLINE Link].

34. Kotha V, Walter E, Stimac G, Kim P. Incisional Application of Negative Pressure for Nontraumatic Lower Extremity Amputations: A Review. Surg Technol Int. 2019 May 15. 34:49-55. [QxMD MEDLINE Link].

35. Hoyt BW, Gibson JA, Potter BK, Souza JM. Practice Patterns and Pain Outcomes for Targeted Muscle Reinnervation: An Informed Approach to Targeted Muscle Reinnervation Use in the Acute Amputation Setting. J Bone Joint Surg Am. 2021 Apr 21. 103 (8):681-687. [QxMD MEDLINE Link].

36. Roepke AM, Turner AP, Henderson AW, Goldberg SB, Norvell DC, Czerniecki JM, et al. A Prospective Longitudinal Study of Trajectories of Depressive Symptoms After Dysvascular Amputation. Arch Phys Med Rehabil. 2019 Aug. 100 (8):1426-1433.e1. [QxMD MEDLINE Link].

37. Villarreal JV, Hussien DG, Panchbhavi VK, Jupiter DC. Predisposing Factors for 30-Day Complications Following Leg Amputation. Foot Ankle Spec. 2021 Mar 26. 19386400211001980. [QxMD MEDLINE Link].

Janos P Ertl, MD Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopedic Surgery, Wishard Hospital; Chief, Sports Medicine and Arthroscopy, Indiana University School of Medicine

Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, Sierra Sacramento Valley Medical Society

Disclosure: Nothing to disclose.

William J Brackett, MD Research Assistant, Department of Orthopedic Surgery, Indiana University School of Medicine

Disclosure: Nothing to disclose.

William Ertl, MD Clinical Assistant Professor, Department of Orthopedics, University of Oklahoma College of Medicine

Disclosure: Nothing to disclose.

James W Pritchett, MD Chief of Orthopedic Surgery, Swedish Orthopedic Institute; Active Staff, Swedish Medical Center

James W Pritchett, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, Washington State Medical Association, Association of Bone and Joint Surgeons

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS Professor of Orthopedic Surgery, Chief, Division of Foot and Ankle Surgery, Director, Foot and Ankle Fellowship Program, Department of Orthopedic Surgery, University of Texas Medical Branch School of Medicine

Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Orthopaedic Trauma Association, Texas Orthopaedic Association

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Styker.

James K DeOrio, MD Professor of Orthopedics, Director, Duke Foot and Ankle Fellowship, Duke University Medical Center, Duke University School of Medicine; Associate Professor, Mayo Clinic College of Medicine; Clinical Assistant Professor, F Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences

James K DeOrio, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Foot and Ankle Society, Association of Graduates, United States Air Force Academy, Doctors Mayo Society, Mayo Clinic Alumni Association, Society of Air Force Clinical Surgeons, Society of Military Orthopaedic Surgeons

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Exactech; Treace Medical; Additive; Mirus; Crossroads Orthopedics<br/>Serve(d) as a speaker or a member of a speakers bureau for: Exactech; Treace Medical; Additive; Mirus; WoultersKluwer; Crossroads Orthopedics<br/>Received income in an amount equal to or greater than $250 from: Exactech; Treace Medical; Additive; Mirus; WoultersKluwer; Crossroads Orthopedics.

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