NEUMAN L A, JONES R A
Calif Med. 1961 Aug;95(2):88-91.
Of 105 consecutive supracondylar amputations done at the San Diego County General Hospital during the five-year period, 1953-58, 88 were in patients more than 60 years of age. Occlusive arterial disease was the reason for operation in 85 of the 88 cases. Presenting complaints at the time of amputation were gangrene in 45 cases, pre-gangrene associated with severe pain in 34. Acute arterial occlusion as a cause of thigh amputation was infrequent. The average age of patients requiring thigh amputation from complications of arteriosclerosis obliterans was 78.3 years; for those with diabetic arteriosclerosis or embolism it was about seven and a half years less. Supracondylar amputation was considered the procedure of choice in the elderly debilitated patients with far-advanced occlusive diffuse arteriosclerosis, complicated by gangrene, ulcer and infection of the toes or feet. Sympathectomy and direct arterial operation if done early in the course of the disease may postpone or prevent subsequent amputation. The surgical mortality rate (first two weeks) for supracondylar amputation was 12.5 per cent. More than two-thirds of the deaths were due to bronchopneumonia.
在1953年至1958年的五年期间，圣地亚哥县总医院连续进行了105例髁上截肢手术，其中88例患者年龄超过60岁。在这88例病例中，85例的手术原因是闭塞性动脉疾病。截肢时的主要主诉为45例坏疽，34例为伴有剧痛的坏疽前期。急性动脉闭塞作为大腿截肢的原因并不常见。因闭塞性动脉硬化并发症而需要进行大腿截肢的患者平均年龄为78.3岁；患有糖尿病性动脉硬化或栓塞的患者平均年龄则小约7.5岁。对于患有晚期闭塞性弥漫性动脉硬化、并发坏疽、脚趾或足部溃疡及感染的老年体弱患者，髁上截肢被视为首选手术。如果在疾病早期进行交感神经切除术和直接动脉手术，可能会推迟或避免后续截肢。髁上截肢的手术死亡率（前两周）为12.5%。超过三分之二的死亡是由支气管肺炎导致的。
