Risks Factors Associated With Major Lower Extremity Amputation After Vertical Contour Calcanectomy

Area of Science:

• Orthopedic Surgery
• Podiatric Surgery
• Vascular Surgery

Background:

• Vertical Contour Calcanectomy is a surgical procedure for foot and ankle conditions.
• Major lower extremity amputation is a serious complication following such procedures, particularly in patients with comorbidities.
• Understanding risk factors is crucial for improving patient outcomes and limb salvage rates.

Purpose of the Study:

• To determine the risks associated with major lower extremity amputation after Vertical Contour Calcanectomy.
• To identify patient-specific factors influencing limb salvage and postoperative ambulatory status.
• To compare outcomes between fully ambulatory and partially/nonambulatory patients post-procedure.

Main Methods:

• Retrospective analysis of 63 patients who underwent Vertical Contour Calcanectomy.
• Multivariate logistic regression to identify risk factors for amputation and ambulation.
• Subanalysis comparing ambulatory versus nonambulatory patient groups.

Main Results:

• Primary closure at surgery was associated with a significantly higher likelihood of limb salvage (OR 0.20).
• Female patients were less likely to undergo major lower extremity amputation compared to males (OR 0.15).
• Coronary artery disease (OR 5.18) and preoperative nonambulatory status (OR 10.28) increased the likelihood of poor postoperative ambulation.

Conclusions:

• Primary closure during Vertical Contour Calcanectomy is a key factor in reducing major lower extremity amputation risk.
• Preoperative ambulatory status and the presence of coronary artery disease are significant predictors of postoperative ambulation.
• Female sex is associated with a lower risk of major lower extremity amputation.