Concomitant Orthopedic Injury is the Strongest Predictor of Amputation in Extremity Vascular Trauma

Mabarak, Dimitri; Behzadi, Faraz; Yang, Maelee; Wozniak, Amy; Patel, Palak; Aulivola, Bernadette

doi:10.1016/j.avsg.2022.12.065

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…2,20 Blunt mechanism is frequently associated with higher rates of amputation. 21 This may be explained by higher ISS and higher associated musculoskeletal, neurovascular, and soft tissue injuries often seen in blunt trauma. Mechanism was not a predictor for eventual amputation in our study after adjusting for covariates.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Venous Thromboembolism and Eventual Amputation in Traumatic Femoral and Iliac Vein Injuries: A Trauma Quality Improvement Program Analysis

Falcon,

Caballero,

Filiberto

et al. 2024

The American Surgeon™

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Background Iliac and femoral venous injuries represent a challenging dilemma in trauma surgery with mixed results. Venous restoration of outflow (via repair or bypass) has been previously identified as having higher rates of VTE (venous thromboembolism) compared to ligation. We hypothesized that rates of VTE and eventual amputation were similar whether restoration of venous outflow vs ligation was performed at initial operation. Methods Patients in the 2019-2021 National Trauma Data Bank with iliac and femoral vein injuries were abstracted and analyzed. The primary outcomes of interest were in-hospital lower extremity amputation and VTE. Results A total of 2642 patients with operatively managed iliac and femoral vein injuries were identified VTE was found in 10.8% of patients. Multivariable logistic regression was performed and identified bowel injury, higher ISS, older age, open repair, and longer time to VTE prophylaxis initiation as independent predictors of VTE. Amputation was required in 4.2% of patients. Multivariable logistic regression identified arterial or nerve injury, femur or tibia fracture, venous ligation, percutaneous intervention, fasciotomy, bowel injury, and higher ISS as independent factors of amputation. Conclusion Venous restoration was not an independent predictor of VTE. Venous ligation on index operation was the only modifiable independent predictor of amputation identified on regression analysis.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Venous Thromboembolism and Eventual Amputation in Traumatic Femoral and Iliac Vein Injuries: A Trauma Quality Improvement Program Analysis

Falcon,

Caballero,

Filiberto

et al. 2024

The American Surgeon™

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show abstract

“…Above-the-knee amputations have been proven to have a detrimental impact on patients' movement and quality of life due to various factors, such as vascular diseases [1], diabetes [2], or injuries [3]. These are accompanied by an increased rate of mortality [4], morbidity [5], and the appearance of secondary comorbidities, such as chronic lumbar syndrome, osteoarthritis, osteoporosis, and phantom limb pain [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Biomechanics of Ascending and Descending Stairs in a Patient with Transfemoral Amputation and Neural Sensory Feedback: A Case Report

et al. 2023

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(1) Background: Asymmetry in gait could pose a problem for patients with transfemoral amputation, due to a higher risk for secondary comorbidities. Gait analysis during ascending and descending stairs (20 stair ascends and descends) was conducted in a patient with a unilateral transfemoral amputation and integrated neural sensory feedback (NSFB), with the aim to compare biomechanical parameters between the healthy and the prosthetic leg in conditions with and without NSFB. (2) Methods: Transversal-type research was conducted at the beginning of the patient’s rehabilitation and without prior gait training in conditions with NSFB. Complete study included several months of different gait testing with and without the NSFB. Data analyzed in this study are just a small portion of the overall dataset (only one subject, one recording session, reduced amount of trials in one condition), used for showing the validity of the proposed methodology for gait analysis and proving proof of concept. The analyzed parameters included stance, time, and speed of ascending and descending stairs in conditions with and without NSFB, measured for both legs. The data were processed using statistical software (SPSS Statistics version 24), with descriptive statistics and paired-sample t-tests to determine differences in gait parameters between the healthy and the prosthetic leg. (3) Results: The results revealed statistically significant differences (p = 0.00) in all three examined parameters (stance, time, and speed) between conditions with and without NSFB. (4) Conclusions: Gait stance, time, and the speed of ascending and descending stairs can be controlled and tailored in real time using NSFB.

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Management of Traumatic Radial and Ulnar Artery Injuries and Risk Factors for Amputation

Stuber¹,

Filiberto²,

Lenart³

et al. 2023

Journal of Surgical Research

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Concomitant Orthopedic Injury is the Strongest Predictor of Amputation in Extremity Vascular Trauma

Cited by 3 publications

References 22 publications

Risk Factors for Venous Thromboembolism and Eventual Amputation in Traumatic Femoral and Iliac Vein Injuries: A Trauma Quality Improvement Program Analysis

Risk Factors for Venous Thromboembolism and Eventual Amputation in Traumatic Femoral and Iliac Vein Injuries: A Trauma Quality Improvement Program Analysis

Biomechanics of Ascending and Descending Stairs in a Patient with Transfemoral Amputation and Neural Sensory Feedback: A Case Report

Management of Traumatic Radial and Ulnar Artery Injuries and Risk Factors for Amputation

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