Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


These facts furnish us with indications as to the seat and method of
amputation. Experience has proved that in senile gangrene of the lower
extremity the most reliable and satisfactory results are obtained by
amputating in the region of the knee, care being taken to perform the
operation so as to leave the prepatellar anastomosis intact by retaining
the patella in the anterior flap. The most satisfactory operation in
these cases is Gritti's supra-condylar amputation. Haemorrhage is easily
controlled by digital pressure, and the use of a tourniquet should be
dispensed with, as the constriction of the limb is liable to interfere
with the vitality of the flaps.

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