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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...

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Regenerative Peripheral Nerve Interface: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain
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[Pirogow's amputation as an alternative to lower leg amputation?].

M Bueschges1, C Ottomann, K Mauss

  • 1Sektion für Plastische Chirurgie und Handchirurgie, Intensiveinheit für Schwerbrandverletzte, Universitätsklinikum -Schleswig Holstein Campus Lübeck, Lübeck. michaelbueschges@gmx.de

Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|March 8, 2013
PubMed
Summary

Pirogow amputation offers comparable patient satisfaction to lower leg amputation, with improved mobility and leg length. However, higher revision rates necessitate careful consideration for diabetic or perfusion-impaired patients.

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Area of Science:

  • Orthopedic Surgery
  • Podiatric Surgery

Background:

  • Pirogow amputation is an ankle-level procedure rarely performed (0.1% of lower limb amputations).
  • It offers potential advantages in patient mobility without prosthesis.

Purpose of the Study:

  • To compare patient outcomes of Pirogow amputation versus traditional lower leg amputation.
  • To evaluate pain, functional status, radiological assessment, leg length discrepancy, and mobility.

Main Methods:

  • A prospective study comparing 20 Pirogow amputations with 20 lower leg amputations.
  • Patient-reported outcomes assessed via an Ankle Score questionnaire at 12 months post-operation.
  • Evaluation criteria included pain, functional and radiological assessment, leg length difference, and prosthesis-free mobility.

Main Results:

  • 65% of Pirogow amputation patients reported excellent/very good results, compared to 60% in the lower leg amputation group.
  • Pirogow amputation resulted in a significantly reduced leg length difference and increased prosthesis-free mobility.
  • Postoperative complication and revision rates were higher in the Pirogow group (30%) versus the lower leg amputation group (20%).

Conclusions:

  • Pirogow amputation is a viable alternative to lower leg amputation, offering significant benefits in mobility and leg length equalization.
  • Careful patient selection is crucial, especially for individuals with diabetes or compromised lower extremity perfusion, due to a higher risk of revision surgery.
  • Successful Pirogow amputations provide excellent functional outcomes and patient satisfaction.