RT Journal
A1 Gibbons GW, Wheelock FC, Jr, Hoar CS, Jr, Rowbotham JL, Siembieda C
T1 PRedicting success of forefoot amputations in diabetics by noninvasive testing
JF Archives of Surgery
JO Archives of Surgery
YR 1979
FD September 1
VO 114
IS 9
SP 1034
OP 1036
DO 10.1001/archsurg.1979.01370330056010
UL http://dx.doi.org/10.1001/archsurg.1979.01370330056010
AB • Sixty-six diabetic patients underwent needed forefoot amputations when clinical assessment indicated a reasonable chance of healing. All patients underwent noninvasive testing consisting of segmental systolic pressure measurements and pulse volume recordings (PVRs) taken at the thigh, calf, ankle, and forefoot levels. Segmental systolic pressures were falsely high (>200 mm Hg) and therefore not useful in 56%. Ankle systolic pressures predicted failure in 36% of patients who healed and success in 64% who failed to heal. Segmental PVRs were sequentially predictive in only 50%. Forefoot PVR traces predicted failure in 50% of patients whose amputations healed. No patient should be denied a forefoot amputation solely on the basis of unfavorable results of noninvasive tests. Favorable clinical signs and a strongly positive forefoot PVR trace are the best predictors of successful forefoot amputations in diabetic patients.(Arch Surg 114:1034-1036, 1979)