Mangled Extremity

Tufescu, Ted

doi:10.1002/9781444345100.ch75

Cited by 2 publications

(4 citation statements)

References 30 publications

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“…However, some studies have reported that limb salvage is not always the best solution and that early amputation with prosthetic treatment should be recommended in some cases. 4 , 5 , 6 , 7…”

Section: Introductionmentioning

confidence: 99%

“…Scores greater than or equal to seven have predictive value for limb amputation. 4 According to Tufescu, 6 evaluation scores predict limb salvage, and not amputation or the functioning of the salvaged limb. For this reason, they cannot be used as the only tool for choosing the treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Some of the sociodemographic factors relating to the patient may be predictive of unfavorable clinical outcomes, both for amputation and for limb salvage: advanced aged, low educational level, poverty, smoking and low motivation. 6 …”

Section: Introductionmentioning

confidence: 99%

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Analysis of the characteristics of patients with open tibial fractures of Gustilo and Anderson type III

Neto

Canal

Alves³

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo analyze the characteristics of patients with Gustilo–Anderson Type III open tibial fractures treated at a tertiary care hospital in São Paulo between January 2013 and August 2014.MethodsThis was a cross-sectional retrospective study. The following data were gathered from the electronic medical records: age; gender; diagnosis; trauma mechanism; comorbidities; associated fractures; Gustilo and Anderson, Tscherne and AO classifications; treatment (initial and definitive); presence of compartment syndrome; primary and secondary amputations; MESS (Mangled Extremity Severity Score) index; mortality rate; and infection rate.Results116 patients were included: 81% with fracture type IIIA, 12% IIIB and 7% IIIC; 85% males; mean age 32.3 years; and 57% victims of motorcycle accidents. Tibial shaft fractures were significantly more prevalent (67%). Eight patients were subjected to amputation: one primary case and seven secondary cases. Types IIIC (75%) and IIIB (25%) predominated among the patients subjected to secondary amputation. The MESS index was greater than 7 in 88% of the amputees and in 5% of the limb salvage group.ConclusionThe profile of patients with open tibial fracture of Gustilo and Anderson Type III mainly involved young male individuals who were victims of motorcycle accidents. The tibial shaft was the segment most affected. Only 7% of the patients underwent amputation. Given the current controversy in the literature about amputation or salvage of severely injured lower limbs, it becomes necessary to carry out prospective studies to support clinical decisions.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of the characteristics of patients with open tibial fractures of Gustilo and Anderson type III

Neto

Canal

Alves³

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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“…shows the 58 articles that were entered into the final SLR study, with 46 single studies, 11 multiple studies, and 21 with control groups. There was 1 study determined to be LOE 18, 29 LOE 2 9-37 , and 28 LOE 3 , with 15 determined to achieve QE 18,11,14,16,18,24,25,31,43,44,46,48,50,55,63,65 , 37 QE 29,10,12,13,15,17,19,21,[26][27][28][29][30][32][33][34][35][36][37][38][39][40][41][42]47,49,51,52,[56][57][58][59][60][61]…”

mentioning

confidence: 99%

The Ethical Triage and Management Guidelines of the Entrapped and Mangled Extremity in Resource Scarce Environments: A Systematic Literature Review

Weinstein

Gosney

Ragazzoni

et al. 2020

Disaster med. public health prep.

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Objective: A systematic literature review (SLR) was performed to elucidate the current triage and treatment of an entrapped or mangled extremity in resource scarce environments (RSEs). Methods: A lead researcher followed the search strategy following inclusion and exclusion criteria. A first reviewer (FR) was randomly assigned sources. One of the 2 lead researchers was the second reviewer (SR). Each determined the level of evidence (LOE) and quality of evidence (QE) from each source. Any differing opinions between the FR and SR were discussed between them, and if differing opinions remained, then a third reviewer (the other lead researcher) discussed the article until a consensus was reached. The final opinion of each article was entered for analysis. Results: Fifty-eight (58) articles were entered into the final study. There was 1 study determined to be LOE 1, 29 LOE 2, and 28 LOE 3, with 15 determined to achieve QE 1, 37 QE 2, and 6 QE 3. Conclusion: This SLR showed that there is a lack of studies producing strong evidence to support the triage and treatment of the mangled extremity in RSE. Therefore, a Delphi process is suggested to adapt and modify current civilian and military triage and treatment guidelines to the RSE.

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Mangled Extremity

Cited by 2 publications

References 30 publications

Analysis of the characteristics of patients with open tibial fractures of Gustilo and Anderson type III

Analysis of the characteristics of patients with open tibial fractures of Gustilo and Anderson type III

The Ethical Triage and Management Guidelines of the Entrapped and Mangled Extremity in Resource Scarce Environments: A Systematic Literature Review

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