Below knee amputations (BKA) involve the surgical removal of the distal lower leg, ankle and foot, including the soft tissues, and is often a life-saving procedure. Generally, below-knee amputation is preferred over above-knee amputation, as it has better rehabilitation and functional results 1,2.
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Indications
There are three main categories of indications for proceeding with the below-knee amputation, including the following cases 1:
serious necrotizing soft tissue infections or uncontrollable bleeding where life-saving source control is needed
trauma cases with serious neurovascular compromise, irreparable soft tissue injuries, or full-thickness burns involving most of the extremity
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elective below-knee amputation
non-septic patients suffering from extensive non-healing tissue loss
multiple foot amputations with persistent infection
irreparable vascular insufficiency with a non-healing ulcer
Contraindications
vascular insufficiency at the planned amputation site
hemodynamic instability except where there life-threatening necrotizing soft issue infection or uncontrollable bleeding
Complications
Acute complications
bleeding
infection
acute postoperative pain
Chronic complications
neuroma from transected nerves 3
phantom limb pain
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