•Generally, this finding is noted on patient history, or identifiable on physical exam.
Always look at your patient
•Leg amputation.
BKA – below the knee amputation
AKA – above the knee amputation
•Level of amputation will depend on multiple factors
Reason for the amputation (example: level of traumatic injury)
Blood flow!!!
If blood flow around an injury (traumatic, ulcer, infection, osteonecrosis, etc.) is poor, the area won’t heal unless the amputation is at a level with good blood flow.
•Special note to future surgeons:
•Always be mindful of profusion (blood flow) to the limb. A diabetic foot ulcer may result in a trans-metatarsal amputation (amputation within the foot), but it doesn’t heal. So then amputation at the ankle occurs, but it doesn’t heal. Then a BKA, which doesn’t heal (often referred to as “stump complications”). Finally, an AKA is completed, and heals. This is 4x the surgeries (and 4x associated surgical risk and post-operative risk) when all we needed to do was check blood flow in the leg first (usually via CTA or angiogram).
