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Salvaged limbs after tibial shaft fractures with extensive soft-tissue injury: a biopsychosocial function analysis
A H Karladani1, H Granhed, I Fogdestam
1Department of Orthopedics, Sahlgrenska University Hospital, Göteborg University, S-413 45 Göteborg, Sweden. abbas.karladani@orthop.gu.se
Background:
The purpose of this study was to perform a biopsychosocial function analysis of the outcome in patients with a salvaged leg after tibial shaft fractures associated with extensive soft-tissue injury.
Methods:
A retrospective review of 18 consecutive patients with tibial shaft fractures and extensive soft-tissue damage with a mean Injury Severity Score of 31 was undertaken. All patients were assessed for their physical function, psychological status, and general function.
Results:
The range of motion and torque of the ankle joint were severely affected. The knee joint was affected, but only with regard to the torque during concentric muscular activities. Nottingham Health Profile scores showed that the general and social function for these patients were significantly affected. Five of 18 patients suffered from depression.
Conclusion:
Salvage procedures should be advocated if possible, but careful selection of patients on the basis of mental and social factors is crucial for the outcome.