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[Quality of life after complex tibial reconstruction]
1Abteilung für Plastische und Wiederherstellungschirurgie, Technische Universität, Klinikum rechts der Isar, München.
Der Unfallchirurg
|December 29, 1998
Summary
Limb salvage surgery for severe open tibial fractures (Gustilo IIIB) yields high patient satisfaction despite long-term quality of life impacts. Most patients do not regret limb-saving treatment over amputation.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Reconstructive Surgery
Context:
- Gustilo IIIB open tibial fractures represent severe trauma requiring complex management.
- Microvascular free tissue transfer is a key reconstructive technique for these injuries.
- Long-term outcomes and quality of life after limb salvage are crucial considerations.
Purpose:
- To evaluate the long-term life satisfaction and treatment outcomes in patients with Gustilo IIIB open tibial fractures treated with limb salvage.
- To compare patient-reported outcomes with general population data.
- To assess patient satisfaction with reconstructive surgery, aesthetics, and functional results.
Summary:
- A study investigated 58 patients 6 years post-treatment for Gustilo IIIB open tibial fractures using serial debridements, osteosynthesis, and microvascular free tissue transfer.
- Life satisfaction, assessed via the FLZ questionnaire, showed significant discrepancies in areas like recreation, income, occupation, and pain compared to the healthy West German population.
- Despite critical judgments on aesthetics, donor site morbidity, and pain, 91% of patients were satisfied with the long-term treatment result, with no patient preferring amputation.
Impact:
- Limb salvage for Gustilo IIIB fractures provides satisfying long-term results and high patient satisfaction.
- Multidisciplinary treatment protocols are effective for limb salvage in complex fractures.
- While limb salvage is preferred over amputation, a reduction in quality of life in specific domains should be acknowledged.