Lower extremity amputation is among the oldest known surgical procedures in medical history. Despite the passage of over two millennia, however, relatively little has changed in the operative approach. Currently, lower limb amputation is indicated most frequently for lower extremity compromise due to severe peripheral vascular disease, followed in short order by trauma, tumors, infections and congenital limb deficiencies. Estimates of frequency of lower limb amputations range from 30,000-40,000 cases per year in the United States alone.