The most commonly selected site of amputation of a gangrenous or arterially insufficient leg has been at a level above the knee. This preference has persisted despite the accepted fact that the midcalf amputation provides a more functional limb. In addition to a more satisfactory rehabilitation, several authors have stressed the advantages of a lower mortality rate and a decreased incidence of stump pain associated with amputations below the knee.4,5 However, the fear of poor healing has deterred more frequent consideration of midcalf amputation for peripheral vascular disease. Therefore, a clinical study of 52 cases has been carried out to determine the applicability of midcalf amputation for arterial insufficiency and to investigate parameters which could aid in the predictability of primary healing.
During the period extending from 1948 through 1958, sixty-three midcalf amputations were performed on the private and ward services at the Strong Memorial Hospital. Only