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Is amputation a viable treatment option in lower extremity trauma?
M Barla1, B Gavanier1, M Mangin1
1Service de chirurgie orthopédique, traumatologique et arthroscopique, CHRU de Nancy, 44, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|July 18, 2017
Summary
Early amputation for lower extremity trauma offers advantages, including fewer complications and shorter hospital stays, compared to limb-salvage. This study supports early amputation as a viable treatment option, not a failure, for complex trauma cases.
Area of Science:
- Orthopedic Surgery
- Trauma Management
- Reconstructive Surgery
Background:
- Lack of consensus exists regarding optimal treatment for lower extremity trauma.
- Debate centers on early amputation versus limb salvage to prevent complications.
Purpose of the Study:
- To evaluate early amputation as a viable treatment option for lower extremity trauma.
- To compare outcomes of early amputation versus limb-salvage procedures.
Main Methods:
- Retrospective study of 20 early amputation and 16 limb-salvage patients.
- Minimum 1-year follow-up.
- Assessment using Mangled Extremity Severity Score (MESS), complication rates, bone union, and functional outcomes.
Main Results:
- Amputation group had higher MESS scores (7.8 vs. 4.9, P<0.00001).
- Amputees experienced shorter hospital stays (P<0.022) and fewer complications (P<0.003), particularly infections (P<0.001).
- Limb-salvage patients had a 61% infection rate; no significant quality-of-life difference was observed long-term.
Conclusions:
- Early amputation is a viable treatment for lower extremity trauma, offering benefits in complication management.
- Amputation should be viewed as a strategic choice, considering the functional impact of limb-salvage complications.
- Both early amputation and limb salvage have distinct advantages and disadvantages.
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