A common reason for a lower leg amputation is vascular disease such as peripheral arterial disease (pAVD), also known as smoker's leg or shop window disease. Often, if pAVD is present, several toe or forefoot amputations precede the decision to remove the entire lower leg. Other reasons include serious accidents or circulatory or wound healing disorders in diabetes mellitus.
In a below-knee amputation, the leg is surgically severed below the knee. By preserving the knee joint, the ability to bend is largely retained. The exact amputation height is decided individually, depending on the condition of the vessels or tissue. During the amputation, care is taken to carefully suture the large vessels and leave enough soft tissue and skin to create a weight-bearing residual limb to which a prosthesis can be fitted.