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Association of Specific Lower Extremity Injuries With Delayed Amputation
Susan L Eskridge1, Owen T Hill2, Mary C Clouser1
1Leidos, 140 Sylvester Road, San Diego, CA.
Military Medicine
|October 30, 2018
Summary
Specific lower extremity injuries, particularly calcaneus fractures combined with nerve or vessel damage, significantly increase the risk of delayed amputation in combat-injured service members. These findings aid acute care decisions.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Military Medicine
Background:
- Delayed amputations occur in combat-injured service members despite interventions.
- Identifying specific injury patterns associated with delayed amputation is crucial for improving patient outcomes.
Purpose of the Study:
- To determine if specific lower extremity (LE) injuries are associated with an increased risk of delayed amputation in combat-injured service members.
Main Methods:
- A retrospective analysis of the Expeditionary Medical Encounter Database (2003-2015) was conducted.
- Lower extremity injuries were categorized using the Abbreviated Injury Scale (AIS).
- Logistic regression analyzed the association between specific LE injuries and delayed amputation in 2,996 service members.
Main Results:
- Delayed amputation occurred in 10.3% of service members.
- Navicular, talus, and calcaneus fractures showed the highest rates of delayed amputation.
- Combinations of calcaneus fracture with LE nerve or vessel injury, and calcaneus with tibia fractures, showed the highest odds of delayed amputation.
Conclusions:
- Specific combinations of lower extremity injuries substantially increase the odds of delayed amputation.
- Findings can inform clinical decision-making during the acute care of combat-injured service members.
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