Related Experiment Videos
Complications following limb-threatening lower extremity trauma
Anthony M Harris1, Peter L Althausen, James Kellam
1Department of Orthopaedics Trauma Division, Shands Jacksonville, Jacksonville, FL 32209, USA. pod1999@aol.com
Journal of Orthopaedic Trauma
|December 24, 2008
Summary
Severe lower extremity trauma leads to frequent complications like infection and nonunion. Limb reconstruction patients face a higher risk of these issues, often requiring further treatment.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Reconstructive Surgery
Background:
- Severe lower extremity trauma presents significant challenges in patient management.
- Understanding complication rates is crucial for guiding treatment decisions and patient expectations.
Purpose of the Study:
- To determine the incidence and nature of major complications following severe lower extremity trauma.
- To compare complication profiles between amputation and limb reconstruction interventions.
Main Methods:
- A multicenter, prospective, observational study involving 545 patients.
- Data collected over 2 years across eight level-1 trauma centers.
- Complications recorded at multiple intervals post-injury for both amputation and reconstruction groups.
Main Results:
- The amputation group experienced a 5.4% revision rate, with wound infection being the most common complication (34.2% at 3 months).
- The limb reconstruction group had a 3.9% late amputation rate, with wound infection (23.2% at 6 months), osteomyelitis (8.6%), and nonunion (31%) being frequent.
- Complications frequently led to rehospitalization, with reconstruction patients showing a higher likelihood of hospitalization for these issues.
Conclusions:
- Severe lower extremity trauma is associated with substantial complication rates, including wound infection, nonunion, and osteomyelitis.
- A significant proportion of patients require additional inpatient or operative interventions for complications.
- Limb reconstruction is associated with a higher risk of complications compared to primary amputation.
Related Concept Videos
01:24Healing II: Complications
Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
01:15Veins of Lower Limbs
The human body consists of an intricate network of veins responsible for the crucial task of blood drainage from the lower limbs. These veins can be categorized into two main types: deep veins and superficial veins.
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the knee,...
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the knee,...
01:20Arteries of Lower Limbs
The external iliac artery transitions out of the body cavity, entering the femoral region of the lower leg, and is renamed the femoral artery at the point where it traverses the body wall. This artery is responsible for the distribution of blood to the thigh's deep muscles and the skin's ventral and lateral regions, achieved through several minor branches and the lateral deep femoral artery, which also spawns a lateral circumflex artery. The knee area receives blood from the genicular artery,...
01:26Varicose Veins I: Introduction
Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...