Limb Salvage Versus Amputation for the Mangled Extremity: Factors Affecting Decision-Making and Outcomes

Abstract

Complex limb injuries are severe injuries of the extremities that affect most or all components of the limb. Industrial/farm accidents and motor vehicle crashes are the mechanisms of injury for a large proportion of these presentations in the civilian population. While recent advances in surgery have led to more patients with complex limb injuries (that would have qualified for a primary amputation a few decades ago) undergoing limb-reconstruction surgeries, the existing evidence is inconclusive on the merits of limb salvage over amputation. Limb salvage surgery still carries considerable morbidity and mortality risks and requires careful consideration of several factors by the managing surgeons.

“Fix and flap” for an open fracture of the tibia in a 97-year-old patient: A case report of early internal fixation and free flap reconstruction

“…Long-term treatments that are life-threatening or leave a dysfunctional lower limb should be avoided. Life must come before the limb, and early amputation may result in activities of daily living equivalent to those of the preserved limb [ 13 , 14 ].…”