THE STANDARDIZED BELOW-KNEE AMPUTATION AC CORDING TO BRUCKNER IN VASCULAR PATIENTS - EVALUATION OF EARLY AND LATE RESULTS

Objective: The present study aims to evaluate early and late results a fter standardized below-knee amputation according to Bruckner in vascu lar patients. Patients and methods. During the period 1982 to 1989 72 patients with occlusive arterial disease stage IV underwent below-knee amputation at an average age of 69.7 years. 38 of the amputees could be re-investigated at the end of 1991 after an average follow-up of 5. 3 years. Evaluation criteria consisted of wound healing, knee joint pr eservation, prosthetic fitting, stump appearance, gait capacity or amb ulation, the need for assistance by another person and patients own va luation. Accordingly, rehabilitation level was classified to be good, satisfying or dissatisfying. Results. Knee joint preservation rate amo unted to 91.7 % (66 patients). Postsurgical prosthetic fitting could b e achieved in 55 amputees (76.4 %). All the 38 re-investigated stumps were inapparent. 27 of the patients (71.1 %) showed good and 7 patient s (18.4 %) satisfying rehabilitation, whereas the rehabilitation level was dissatisfying in 4 cases (10.5 %). This objective evaluation was affirmed by patients own estimation: 33 amputees (86.6 %) would again agree to the operation. Conclusions. Early as well as late results in this series indicate that the standardized below-knee amputation accor ding to Bruckner promises high rates of healing, knee joint preservati on and thus successful rehabilitation in patients with occlusive arter ial disease.