vascular surgeon's error

vascular surgeon's error

Wieland Kaphingst

Please see: _ <URL Redacted>
( <URL Redacted>)

Dear Colleagues:

Please check the very informatively done web page mentioned above (made by
and for vascular surgeons and their patients)

Unfortunately they produced a one serious error, that I responded to with
the text farther down.

Probably, if you feel as I, it would make sense if some of you would
support this by sending similar statements (only if you agree) from their feedback
page.

Thank you!

Wieland Kaphingst, CPO

TEXT sent:
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Username: Wieland Kaphingst, CPO, biomed. Eng.
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Comments
Congratulations on your very informative web site. One important mistake in
presentation though must have slipped your editors attention: >>Amputations
through the knee joint or just above the knee joint (Gritti-Stokes amputation)
can also sometimes be performed. They were much more popular amputations in
the past but there is little or no advantage for present day patients
compared with above and below knee amputation<< A below the knee amputation
(transtibial) provides a functional advantage to the amputee (semi-physiological
control of knee joint motion and semi-natural control of stance stability). A
true knee disarticulation (you are right: Gritti-Stokes is considered outdated
today)provides the amputee with the advantages of a. considerably less
surgical trauma and an b. an endbearing residual limb. Please consider this an
enormous advantage because one of the problems in transfemoral prosthetic sockets
is transfer of the amputee's weight and of forces and moments of gait at or
to non-physiological weight-bearing surfaces. A transfermoral amputation would
only be recommended whenever any one of the other two cannot be performed by
various reasons (as lack of blood flow in a vascular amputee). Conclusion: -
There is considerable advantage in any transtibial amputation as compared to
knee disarticulations and transfemoral amputations. - There is considerable
bio-mechanical advantage in a knee disarticulation as compared to a
transfemoral amputation. If interested, I will be happy to provide you with reference
literature. Dipl.-Ing. Wieland Kaphingst Certified Prosthetist/Orthotist
(CPO) Biomedical Engineer (BMT)
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