Open tibial fractures with severe soft-tissue loss. Limb salvage compared with below-the-knee amputation.

Georgiadis, Gregory M.; Behrens, Fred F.; Joyce, Michael; Earle, Alison; Simmons, Anne

doi:10.2106/00004623-199310000-00003

Cited by 240 publications

(146 citation statements)

References 42 publications

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“…There is considerable debate whether amputation achieves better results than limb-salvage surgery in the post-traumatic setting [12,32]. Over 20 years ago Giorgiadis, et al suggested that patients with a salvaged limb took longer to full weight-bearing, were less willing to work, had higher hospital charges, were more likely to consider themselves severely disabled, and had more problems with occupational and recreational activities [12].…”

Section: Discussionmentioning

confidence: 99%

“…Over 20 years ago Giorgiadis, et al suggested that patients with a salvaged limb took longer to full weight-bearing, were less willing to work, had higher hospital charges, were more likely to consider themselves severely disabled, and had more problems with occupational and recreational activities [12]. More recently Doukas, et al (the METALS study) suggested that patients undergoing amputation had better functional outcomes than those undergoing limb salvage [11].…”

Section: Discussionmentioning

confidence: 99%

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Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Merwe

Birkholtz

Tetsworth

et al. 2016

Injury

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Purpose:The purpose of this study was to evaluate the functional and psychological outcomes of patients who underwent delayed lower limb amputation following failed limb salvage surgery. Methods:This retrospective, descriptive study evaluated functional outcomes using the Sickness Impact Profile (SIP) and Short Form-36 (SF-36) in 12 patients. Inclusion criteria included patients who underwent limb reconstruction and delayed amputation between between July 2006 and December 2014, with an age range between 18-80 years of age, the ability to ambulate independently, a time interval between the last salvage procedure and amputation greater than six months, and a minimum follow-up of 24 months. Patients were contacted via telephone by the principal investigator and both the Sickness Impact Profile (SIP) and Short Form-36 (SF-36) were completed. Descriptive analysis (means and standard deviation) was used to determine outcomes for both SIP and SF-36 health profiles. Results:Ten patients who had amputations following failed reconstruction (2006-2014) with a mean age of 53+10 years were interviewed. Six patients had a SIP < 5, three patients scored between five and 10 points and one scored >10 points. The main deficit on the SF-36 was in the physical component. The SF-36 scores demonstrated a mean score of 40.8+11.5 for the physical component, and 57.4+7.9 for the mental component. Three patients returned to work after amputation and continued performing their pre-injury duties as farmers.Three other patients returned to work, but were allocated to administrative duties. Two patients were pensioners at the time of their injuries, and the only female patient was a housewife. One patient went into early retirement. Conclusion:The results of this study strongly suggest that delayed amputation following failed limb salvage surgery can still result in good and satisfactory outcomes in the majority of patients and achieves results similar to early amputation and limb reconstruction techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Merwe

Birkholtz

Tetsworth

et al. 2016

Injury

View full text Add to dashboard Cite

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“…30 Whatever the conduit, shunting of tibial level injuries appears to be associated with a high failure rate and a number of patients with concurrent soft tissue and osseus injuries at this level will likely regain the ability to walk more expediently with BKA and prosthesis as compared with multiple complex limb salvage procedures. [31][32][33] This is thought to be a decision best made at higher echelons; however, thus initial limb salvage attempt at forward units is thought to be the most appropriate course of action provided it does not put the patient's life at risk.…”

Section: Discussionmentioning

confidence: 99%

Tactical Surgical Intervention With Temporary Shunting of Peripheral Vascular Trauma Sustained During Operation Iraqi Freedom: One Unit??s Experience

Chambers

Green

Sample

et al. 2006

The Journal of Trauma: Injury, Infection, and Critical Care

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“…Fusions were performed by two-column plating (two) and intramedullary nailing (18). The patients with fusion and with AKA completed specialized questionnaires about their fusion (Appendix 1; supplemental materials are available with the online version of CORR) and their AKA [17], respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Older studies have demonstrated patients with trauma receiving fusion fare worse than those receiving amputation with regard to multiple factors, including more complications and operative procedures, longer hospital stays, worse limb function, and decreased quality of life [16,18]. A recent study demonstrated patients with trauma undergoing lowerlimb reconstruction had similar levels of health when compared to those undergoing amputation at 2-year followup, although patients undergoing fusions were more likely to be rehospitalized compared to those undergoing amputation [8].…”

Section: Introductionmentioning

confidence: 99%

Better Function for Fusions Versus Above-the-knee Amputations for Recurrent Periprosthetic Knee Infection

Chen

Kinback

Heyl

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Treatment of chronic periprosthetic joint infections (PJIs) after TKA is limited to fusions, above-theknee amputations (AKAs), revision TKA, and antibiotic suppression and is often based on the patient's medical condition. However, when both fusion and AKA are options, it is important to compare these two procedures with regard to function. Questions/purposes Do patients receiving a knee fusion for PJI after TKA have better function compared to patients receiving an AKA?Methods We retrospectively reviewed patients who were eligible for either fusion or AKA after PJI TKA. Thirtyseven patients underwent a fusion for PJIs after TKA between 1999 and 2010. Nine patients died postoperatively and eight patients were lost to followup, leaving 20 patients. Patients completed a specialized questionnaire about their fusion, and functional capability was assessed by the SF-12. We compared fusions to a previously published group of six patients who underwent AKA for recurrent PJI after TKA.

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Open tibial fractures with severe soft-tissue loss. Limb salvage compared with below-the-knee amputation.

Cited by 240 publications

References 42 publications

Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Tactical Surgical Intervention With Temporary Shunting of Peripheral Vascular Trauma Sustained During Operation Iraqi Freedom: One Unit??s Experience

Better Function for Fusions Versus Above-the-knee Amputations for Recurrent Periprosthetic Knee Infection

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