Of 190 consecutive patients with below-the-knee amputation done for
diabetic or arteriosclerotic vascular disease, 167 were successfully fitted
with a prosthesis and used the prosthesis in some or all of the activities
of daily living. The surgical failure rate was 4.2 per cent; only eight
patients required surgical revision to a higher level of amputation. The
technique of rigid plaster dressing followed by delayed application of a
plaster cast and pylon was not detrimental to wound healing and did not
increase the interval between surgery and the use of the prosthesis, nor
did it depress the eventual level of function. When compared with our own
previous experience with other flaps, the long posterior flap offered a
significant advantage in healing rate.