Vascular

Above-Knee Amputation

ABOVE-KNEE AMPUTATION (TRANSFEMORAL AMPUTATION)

Indication: Irreversible critical limb ischaemia where below-knee amputation is not possible (inadequate skin perfusion at transtibial level, extensive tissue loss or infection involving the calf, or patient unable to rehabilitate with a below-knee prosthesis). Required when gangrene or infection extends to the knee.

Patient Position: Supine.

Anaesthesia: General or regional.

Prophylactic Antibiotics: Broad-spectrum IV.

Procedure:
1. Amputation level assessed. Ideally, the femur is divided at the mid-thigh level to allow adequate residual limb for prosthetic fitting.
2. Anterior and posterior skin flaps fashioned — equal anterior and posterior flaps or fish-mouth incision.