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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Amputaion Below Knees Advisable When Suffering From Diabetes?

My husband age 67, type 1 diabetic after leaving Navy 40 years ago. Amputated right leg below knee age 60. Peripheral circulation very poor, Diabetic rhetinopathy treated with laser, now amputated left ring toe not healing, on IV antibiotics but blood sugars have gone crazy high.
Should he just opt for amputation again below knee and give up after 3 months of being out of work, feeling sick, and hurting?
Sat, 22 Feb 2014
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General Surgeon,  's  Response
to summarize: long term diabetic with history of Right BKA, now with amputated Right ring toe, which is not healing despite being on antibiotics.
If I were seeing you as a patient, I will be interested to know the Arterial Brachial Index (ABI) of that leg at least, and ideally get an arteriogram in order to visualize the arterial flow down that leg. Given what the arterial flow is, he may not need a below knee amputation. There could be other options if he has good blood flow down to foot even if not up to toes, such as transmetatarsal amputation (where half of foot is cut). Given that I don't have your imaging (ABI, arteriogram), it'll be best to see a vascular surgeon to discuss your options.

Hope this helps.
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Is Amputaion Below Knees Advisable When Suffering From Diabetes?

to summarize: long term diabetic with history of Right BKA, now with amputated Right ring toe, which is not healing despite being on antibiotics. If I were seeing you as a patient, I will be interested to know the Arterial Brachial Index (ABI) of that leg at least, and ideally get an arteriogram in order to visualize the arterial flow down that leg. Given what the arterial flow is, he may not need a below knee amputation. There could be other options if he has good blood flow down to foot even if not up to toes, such as transmetatarsal amputation (where half of foot is cut). Given that I don t have your imaging (ABI, arteriogram), it ll be best to see a vascular surgeon to discuss your options. Hope this helps.