Leg amputation

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Author: Mikael Häggström [notes 1]
Amputation of a leg.

Gross processing

Look up the history of the patient. If the amputation was done for vascular insufficiency, look for any imaging that identifies the most affected large vessels, and focus on examining those.

If ulcer(s) are identified, describe cut surfaces of the underlying bone(s).

For the proximal bony margin, gouge out some of the bone marrow at this location.

Gross report

Example:

((A. Labeled - ___. The specimen is received fresh and consists of)) an above-the-knee amputation, amputated __ cm proximal to the knee (top of patella). The specimen has a total length of __ cm. There has been a previous trans-metatarsal amputation. __ cm of exposed bone is present at the surgical margins. The cutaneous and soft tissue margins appear viable. The skin surface of the specimen is tan and smooth, with a protuberance on the mid-anterior aspect near the tibial tuberosity with an overlying similar wound measuring 4.2 x 3.3 cm. This wound is 19.5 cm from the surgical margin of resection. The major arteries are dissected out from the specimen. The anterior tibial artery shows calcific atherosclerosis with up to 70% luminal occlusion, the posterior tibial artery and peroneal artery with up to 50% occlusion, and dorsalis pedis artery with up to 30% occlusion. Representative sections are submitted for microscopic examination in ___ cassettes following decalcification.


KEY OF SECTIONS:
A1. Bone marrow at margin of resection
A2. Skin and soft tissue margin
A3. Vascular margin
A4. Section of large wound at stump
A5. Section of bone under large wound at stump
A6. Anterior tibial artery
A7. Posterior tibial artery
A8. Peroneal artery
A9. Dorsalis pedis artery

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

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References