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Updated: Jun 2, 2026

Partial Heterotopic Hindlimb Transplantation Model in Rats
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The mangled limb: salvage versus amputation.

Philip R Wolinsky1, Lawrence X Webb, Edward J Harvey

  • 1Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA.

Instructional Course Lectures
|May 11, 2011
PubMed
Summary
This summary is machine-generated.

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Mangled extremity treatment decisions between limb salvage and amputation show similar outcomes. A multidisciplinary team approach is recommended for optimal mangled extremity care.

Area of Science:

  • Orthopaedics
  • Trauma Surgery
  • Plastic Surgery
  • Vascular Surgery

Background:

  • Mangled extremity definition involves injury to at least three of four limb systems.
  • Limb salvage versus amputation decisions are controversial, with varied outcomes reported.
  • Existing scoring systems for limb viability have shown unreliability.

Purpose of the Study:

  • To compare outcomes of limb salvage versus amputation for mangled extremities.
  • To evaluate factors influencing treatment decisions, including patient stability and injury severity.
  • To assess return-to-work status, functional outcomes, and economic costs.

Main Methods:

  • Review of literature on mangled extremity treatment controversies.

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Last Updated: Jun 2, 2026

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  • Analysis of the Lower Extremity Assessment Project (LEAP) study findings.
  • Consideration of patient factors: hemodynamic stability, comorbidities, and injury patterns.

    • Main Results:

    • No significant difference in return-to-work rates between salvage and amputation groups.
    • Functional outcomes and treatment costs (including prosthetics) were comparable for both approaches.
    • Soft-tissue injury severity is a critical factor in determining limb viability.

    Conclusions:

    • Limb salvage is viable only for hemodynamically stable patients.
    • Life-saving interventions take precedence in unstable or critical patients.
    • A collaborative, multidisciplinary team approach is crucial for managing mangled extremities.