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Risk Factors for Lower Extremity Minor Amputation Conversion to Major Amputation
Nicholas P Rolle1, Qingwen Kawaji2, Claire Morton3
1Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA.
Annals of Vascular Surgery
|February 22, 2024
Summary
Minor lower extremity amputations (LEAs) vary in outcomes. Midfoot amputations have higher major amputation conversion rates, while toe/ray amputations see more repeat minor procedures, impacting wound healing and future limb salvage success.
Area of Science:
- Vascular Surgery
- Orthopedic Surgery
- Podiatric Surgery
Background:
- Minor lower extremity amputations (LEAs) are crucial for limb salvage but carry risks.
- Outcomes and conversion to major amputation differ between toe/ray and midfoot amputations.
Purpose of the Study:
- To compare outcomes of toe/ray versus midfoot amputations.
- To identify risk factors for major amputation conversion after minor LEAs.
Main Methods:
- Retrospective chart review of 375 foot amputation patients.
- Comparison of toe/ray vs. midfoot amputation groups.
- Analysis of conversion to major amputation, wound healing, and mortality rates.
Main Results:
- Toe/ray amputations had more repeat minor amputations (34.7%) and better 90-day wound healing.
- Midfoot amputations showed a higher conversion to major LEA (20.8%) within 1 year.
- Overall 1-year mortality was 6.17% with no significant difference between groups.
Conclusions:
- While overall mortality is similar, risk factors for major amputation conversion differ between minor LEA types.
- Findings aid surgeons in selecting appropriate amputation levels.
- Informed patient understanding of healing and repeat amputation risks is enhanced.
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