Through the years voices have been raised from time to time to question the standard thigh amputation for peripheral vascular disease as the only reasonable procedure for the removal of the gangrenous extremity. Among others McKittrick et al.2 championed the transmetatarsal procedure, and Silbert and Haimovici,3 below-the-knee amputation. Nevertheless, most surgeons continue to feel that these operations will not succeed in a very high percentage of cases. It is the purpose of this paper to present a below-the-knee amputation that has produced a well-healed stump in 14 of 15 limbs. All amputations were performed by 1 surgeon or by residents under his direct observation and direction.
The accompanying Table 1 gives the important facts concerning the type of patient selected and the end-results. It will be noted that there were 13 patients. Three were women and 10 men. All had arteriosclerosis except for 1 with Buerger's disease.