56.6 Amputation above the knee

Many above knee amputations for severe injuries could have been avoided, if only a below knee amputation had been done early enough, and not delayed. Provided the stump avoids the condyles of a patient’s femur, the longer it is the better.

Be sure to exercise the stump immediately after the amputation, so as to strengthen: (1) the patient’s remaining adductor muscles, and prevent the prosthesis moving outwards when he walks, and (2) his extensors, because they will have to extend both his hip and the prosthesis which is to form his knee. He will also have to learn to balance with his hip instead of his foot muscles.

Study the anatomy of his leg carefully, so that you can find his subsartorial canal fast, and tie his femoral artery. The canal and its vessels are described in Section 3.6.

Figure 56.11: AMPUTATING ABOVE THE KNEE. Provided the stump avoids the condyles of a patient’s femur, the longer it is the better.