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Functional outcomes following trauma-related lower-extremity amputation
Ellen J MacKenzie1, Michael J Bosse, Renan C Castillo
1Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 554, Baltimore, MD 21205, USA. emackenz@jhsph.edu
The Journal of Bone and Joint Surgery. American Volume
|August 5, 2004
Summary
Functional outcomes after trauma-related lower-extremity amputation show severe disability regardless of level. Through-the-knee amputations yielded worse results, highlighting the need for careful evaluation and further prosthetic research.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Trauma Surgery
Background:
- Trauma-induced lower-extremity amputations present significant functional challenges.
- Amputation level is a critical factor influencing patient outcomes.
Purpose of the Study:
- To evaluate functional outcomes in patients with trauma-related lower-extremity amputations.
- To compare outcomes based on amputation levels (above-the-knee, through-the-knee, below-the-knee).
- To identify factors influencing outcomes beyond amputation level.
Main Methods:
- Prospective cohort study of 161 patients with above-the-ankle amputations.
- Functional status assessed using the Sickness Impact Profile (SIP).
- Secondary outcomes included pain, mobility, walking speed, and physician satisfaction; analyzed with multivariate regression.
Main Results:
- No significant SIP score difference between above-the-knee and below-the-knee amputations.
- Below-the-knee amputations showed better walking speed than above-the-knee.
- Through-the-knee amputations resulted in worse SIP scores and slower walking speeds.
- Physical function differences were most pronounced by amputation level; physician satisfaction was lowest for through-the-knee.
Conclusions:
- Significant disability follows trauma-related lower-extremity amputation, irrespective of level.
- Clinicians should carefully consider the necessity of through-the-knee amputations.
- Further research is needed on prosthetic devices and their impact on functional outcomes.