Factors affecting outcome after traumatic limb amputation

Abstract

Background: Traumatic leg amputation commonly affects young, active people and leads to poor longterm outcomes. The aim of this review was to describe common causes of disability and highlight therapeutic interventions that may optimize outcome after traumatic leg amputation.Methods: A comprehensive search of MEDLINE, Embase and Cumulative Index to Nursing and Allied Health Literature databases was performed, using the terms 'leg injury', 'amputation' and 'outcome'. Articles reporting outcomes following traumatic leg amputation were included.Results: Studies demonstrated that pain, psychological illness, decreased physical and vocational function, and increased cardiovascular morbidity and mortality were common causes of disability after traumatic leg amputation. The evidence highlights that appropriate preoperative management and operative techniques, in conjunction with suitable rehabilitation and postoperative follow-up, can lead to improved treatment outcome and patient satisfaction. Conclusion:Patients who undergo leg amputation after trauma are at risk of poor long-term physical and mental health. Clinicians involved in their care have many opportunities to improve their outcome using a variety of therapeutic variables.

Anxiety and depression following traumatic limb amputation: A systematic review

“…Perkin's review found a significant increase in anxiety and depression compared to the population average with femoral amputation but not with tibial amputation [13]. This suggests that the higher the severity of the injury, the more likely the patient will be to suffer from a mental illness.…”

Increased peripheral vascular resistance in male patients with traumatic lower limb amputation

“…Perkins et al [7] observed an increase in blood pressure at rest in patients with traumatic amputations compared with nonamputated individuals. In addition, only 1.8% of these patients presented low blood pressure levels.…”

“…The increased morbidity and mortality in amputees can be explained by the development of risk factors, among which high blood pressure plays an important role [6][7][8][9]. Perkins et al [7] observed an increase in blood pressure at rest in patients with traumatic amputations compared with nonamputated individuals.…”

The short musculoskeletal functional assessment (SMFA) score amongst surgical patients with reconstructive lower limb injuries in war wounded civilians

“…The presence of the need for reconstruction in the lower limb after major trauma is by itself a poor prognostic factor for expecting the improvement in the functional index [15]. Amputation is suggested as the best alternative in many studies [7,8] but is called into question by many others [16][17][18].…”