Page 1 of 2 12 LastLast
Results 1 to 10 of 15

Thread: Amputation of leg above the knee?

  1. #1

    Amputation of leg above the knee?

    I had a skin graft three years ago that never healed correctly, meaning that the skin was thin and blistered easily. I was able to deal with the small blisters by staying off my feet, the graft was on the bottom of my foot. So, a BIG blister formed 5 months ago. Saw a plastic surgeon who, after 6 weeks with a Wound Vac pump on my foot, did a SECOND graft!

    Now 3 months later I still have to keep my foot open to the air for 16 hours during a 24 hour day because there is a 3"X3" area that is open and heeling S L O W L Y.

    I have been taking 1,200 mg of a Sulfa drug daily for the past six weeks because of a staph infection.

    I NEED the foot GONE in order to have a life! But because of poor circulation in my legs just the foot being removed there would still be problems. It would have to be above the knee so so I have been told.

    Question, are there any SCI's who had their leg at the knee removed who can give me some advice and tips?
    Gary Is = L-1 Para for 34 years.....................
    ~~~~~~~~~~

  2. #2
    Senior Member
    Join Date
    Jan 2004
    Location
    Whately, MA United States
    Posts
    2,685
    Blog Entries
    2
    I don't remember any details, but there was at least one member who may have had both legs amputated, and s/he was really happy with the results. I remember that there were a lot of responses that it was a really bad idea. I'll do a search...

    Here's the thread, and the 14th or 15th post was about a guy who was glad he did it.http://sci.rutgers.edu/forum/showthr...ble-amputation
    Last edited by Donno; 06-12-2014 at 08:21 PM. Reason: more info
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  3. #3
    Have you had studies of your circulation in your legs? Often with a poorly healing wound or graft like this we find that the person has severe peripheral vascular disease that has previously be undiagnosed. Are you diabetic? Have you seen a vascular surgeon? Gotten a second opinion from another plastic surgeon?

    Above the knee amputations can be difficult to heal as well if you have poor blood flow. In addition, if a lot of the thigh is removed, this significantly increases your risks for ischial pressure ulcers, as many cushions for pressure ulcer prevention work by off-loading the ischial weight onto the posterior thighs. If you don't have thighs, then all the weight it put onto the ischiums. You would definitely need a complex and comprehensive seating evaluation even with just one leg amputated above the knee.

    (KLD)

  4. #4
    Quote Originally Posted by SCI-Nurse View Post
    Have you had studies of your circulation in your legs? Often with a poorly healing wound or graft like this we find that the person has severe peripheral vascular disease that has previously be undiagnosed. Are you diabetic? Have you seen a vascular surgeon? Gotten a second opinion from another plastic surgeon?

    Above the knee amputations can be difficult to heal as well if you have poor blood flow. In addition, if a lot of the thigh is removed, this significantly increases your risks for ischial pressure ulcers, as many cushions for pressure ulcer prevention work by off-loading the ischial weight onto the posterior thighs. If you don't have thighs, then all the weight it put onto the ischiums. You would definitely need a complex and comprehensive seating evaluation even with just one leg amputated above the knee.

    (KLD)
    My plastic surgeon is a T-12 paraplegic. (The go to doctor for shark damage to arms legs feet etc.)

    Today he agreed, finally, to do a below the knee amputation. "It is up to you to make the decision." Here is a letter I sent him three weeks ago, todays visit was the first time that I saw him since the letter.


    Doctor xxxxxx
    6.16.14


    I need to express some thoughts and feelings about my foot. I am probably one of your most careful and cautious patients.


    Accidents happen, the first life altering accident that happened was the fault of both the crane operator and the lack of a safety mechanism that caused me to become a paraplegic. The second accident happened thirty years later spilling hot tea down my shoe. I didn’t get to be a vital strong seventy-six year old paraplegic in good health physically and mentally by being careless.


    The first graft took over five months to heal with the Hale Makua Wound Care Nurses coming twenty-four times. Over the next two years I could not take a bath because even lukewarm water would cause the skin to blister. This occurred twice and I dealt with them myself as they were small in size, and was ‘down’ for up to six weeks each occurrence. Since the new graft I’ve been down for almost five months, (since the day of the blister). A few days ago a new blister opened up. With this vulnerable foot I’ll never have a normal life. I will be living as an invalid.


    I have been living with this foot for the past three years, tender, prone to blistering, prone to shoe irritation, no swimming, no bathing other than sponge baths. I get a weekly lukewarm shower with a hired caregiver with my foot up on a board across the tub and covered to keep warm water from touching it. I spend sixteen to eighteen hours a day with my foot at heart level. I have two large pillows on my bed and the couch. The heel does not rest on any surface, the entire foot is open to air.


    Another concern of mine is long term high dosage antibiotics, (1,200mg of a sulfa drug daily for the past 8 weeks). This is not good for my physical being. I am now experiencing mild diarrhea.


    I appreciate your efforts to save my foot, however, I believe the only solution to allow me to have ‘full rest of my life’ is to have a foot, or leg at the knee amputation. I’ve spoken with my case worker and was told that they would approve this surgery if you deemed it necessary for quality of life reasons. I am keeping depression at bay, but the longer I am dealing with this situation the harder it becomes.

    I am communicating with you in writing because I’d never be able to tell you in such detail in person as time in the office is short.


    I do hope that you will consider this surgery.


    Respectfully,


    Gary Schooley
    Last edited by Garyis; 06-30-2014 at 10:15 PM. Reason: Additional information
    Gary Is = L-1 Para for 34 years.....................
    ~~~~~~~~~~

  5. #5
    I have known about a half dozen SCIs over the year who have had their legs amputated, usually because of sore issues. However, there are downsides. As KLD mentioned, seating becomes problematic. In addition to the pressure sore problems, some experienced major sitting balance and transfer problems. The legs are a ballast that help stabilize the body and AK amputations do away with that benefit. If you go below knee, be sure to have the circulation evaluated. If it is not adequate, it may just result in another sore and the need for a second round of amputations.
    You will find a guide to preserving shoulder function @
    http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

    See my personal webpage @
    http://cccforum55.freehostia.com/

  6. #6
    Senior Member lynnifer's Avatar
    Join Date
    Aug 2002
    Location
    Windsor ON Canada
    Posts
    19,320
    You've exasperated e-stim, vitamin overload (B12, biotin, iron, L-arginine)? Sometimes with a foot wound, having it down at all means a hole for fluid to leak through via swelling which means it will never heal. By this time, there must be bone involvement?

    I would take all of these precautions first before amputation ... I've come close several times but unless I was in sepsis, I refuse. They make nice kickstands when transferring.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  7. #7
    My son had a below the knee amputation in February. He had broken his ankle and with the screws they put in it, it never healed but got worse. The wound was actually starting to go up his leg. He considered amputation because he was afraid of massive infection since it had been open for a year and a half. The doctors agreed with it and it was done. His surgeon had actually done a few surgeries on David and in the end, left more than he originally said. He felt it was better for David's balance in his wheelchair since his leg will still bend. In the end, it was the best thing possible. It healed very quickly and no more worries about massive infection setting in. David is happy with his decision. He is much happier with it off than worrying all the time and I am too. It was a good and smart choice in his case.
    DavesMom, Diane

  8. #8
    Quote Originally Posted by Donno View Post
    I don't remember any details, but there was at least one member who may have had both legs amputated, and s/he was really happy with the results. I remember that there were a lot of responses that it was a really bad idea. I'll do a search...

    Here's the thread, and the 14th or 15th post was about a guy who was glad he did it.http://sci.rutgers.edu/forum/showthr...ble-amputation
    Thanks Donno! I did get some information... the surgery is almost set for 3 weeks from today.It wile a below the knee cut.
    Gary Is = L-1 Para for 34 years.....................
    ~~~~~~~~~~

  9. #9
    Quote Originally Posted by DavesMom View Post
    My son had a below the knee amputation in February. He had broken his ankle and with the screws they put in it, it never healed but got worse. The wound was actually starting to go up his leg. He considered amputation because he was afraid of massive infection since it had been open for a year and a half. The doctors agreed with it and it was done. His surgeon had actually done a few surgeries on David and in the end, left more than he originally said. He felt it was better for David's balance in his wheelchair since his leg will still bend. In the end, it was the best thing possible. It healed very quickly and no more worries about massive infection setting in. David is happy with his decision. He is much happier with it off than worrying all the time and I am too. It was a good and smart choice in his case.
    DavesMom, Diane
    Thanks Diane for the positive note. One never knows what the out come will be, but my doctor is an expert with amputations, I am feeling positive about doing this; I HAVE to do this to have a life worth living.
    Gary Is = L-1 Para for 34 years.....................
    ~~~~~~~~~~

  10. #10
    Garyis, you will be subject to more risk for developing a knee flexion contracture post-op without proper positioning and ROM to your knee than an AB person having the same procedure. Please be sure to discuss prevention of this problem with your surgeon prior to the surgery.

    (KLD)

Similar Threads

  1. Replies: 2
    Last Post: 03-21-2011, 06:22 PM
  2. Amputation for a dog questions?
    By TheDuder in forum Life
    Replies: 13
    Last Post: 01-09-2010, 01:43 AM
  3. C-5 fracture and arm amputation
    By LizzyTish65 in forum New SCI
    Replies: 12
    Last Post: 10-28-2008, 01:46 AM
  4. Help!!! Bad Sore!!! Amputation!!!
    By GoTWHeeLs in forum Care
    Replies: 10
    Last Post: 08-13-2007, 09:18 PM
  5. leg amputation???.....has anyone
    By justadildo in forum Care
    Replies: 26
    Last Post: 08-17-2006, 04:08 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •