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Lower extremity amputation in scleroderma.

M E Reidy1, V Steen, J J Nicholas

  • 1Department of Orthopedics, Passavant Hospital, Pittsburgh, PA.

Archives of Physical Medicine and Rehabilitation
|September 1, 1992
PubMed
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Systemic Sclerosis (SSC) patients undergoing lower limb amputation for nonhealing ulcers experienced successful wound healing and prosthetic use. Many SSC patients can achieve independent ambulation with prostheses after amputation.

Area of Science:

  • Rheumatology
  • Vascular Surgery
  • Orthopedics

Background:

  • Systemic Sclerosis (SSC) is a fibrotic disorder affecting skin and internal organs.
  • Autoamputation of digits is common, but lower limb amputation in SSC patients is rare.
  • Pathological hallmarks include vascular intimal proliferation and scarring.

Purpose of the Study:

  • To evaluate outcomes of lower limb amputation in Systemic Sclerosis patients.
  • To assess the success rate of prosthetic fitting and ambulation post-amputation.

Main Methods:

  • Retrospective review of the Pittsburgh Scleroderma databank (1,030 patients).
  • Analysis of seven patients who underwent lower limb amputation for nonhealing ulcerations.
  • Evaluation of postoperative wound healing and prosthetic use.

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Main Results:

  • Seven SSC patients (4 CREST, 2 diffuse, 1 overlap) underwent amputation.
  • All patients had nonhealing ulcerations; postoperative wound healing was uncomplicated.
  • Three patients were successfully fitted with prostheses and became independent ambulators.

Conclusions:

  • Systemic Sclerosis patients can achieve successful prosthetic use and ambulation after lower limb amputation.
  • Prosthetic prescription should be considered for eligible SSC patients.
  • Comorbidities like atherosclerotic peripheral vascular disease may be present.