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Salvage of the severely injured limb in children: a multidisciplinary approach
Pediatric Emergency Care
|June 1, 1995
Insights
Severe limb trauma can cause loss of function and amputation. A multidisciplinary approach combining vascular repair, fracture fixation, and hyperbaric oxygen therapy can improve limb viability.
Area of Science:
- Trauma surgery
- Vascular surgery
- Orthopedic surgery
- Hyperbaric medicine
Background:
- Massive limb trauma, including open fractures with vascular, crush, and avulsion injuries, can lead to acute peripheral ischemia.
- Such injuries place the extremity at high risk of necrosis and potential amputation, even in pediatric patients.
Observation:
- A combined, multidisciplinary approach is crucial for managing severe limb trauma.
- This approach should integrate immediate vascular repair and fracture fixation.
Findings:
- Early institution of hyperbaric oxygen therapy alongside surgical interventions is recommended.
- This combined strategy aims to enhance tissue viability and prevent limb loss.
Implications:
- This multidisciplinary strategy offers a promising approach to salvage limbs at risk of amputation.
- Improved limb salvage rates can lead to better functional outcomes for patients with severe trauma.
Abstract:
Massive trauma to a limb, even in young children, may lead to loss of viability and function. A combination of open fracture with vascular, crush, and avulsion injury resulting in acute peripheral ischemia may place the extremity at risk of necrosis and imminent amputation. We suggest a combined, multidisciplinary approach that includes initial vascular repair and fractures fixation, with early institution of hyperbaric oxygen therapy.