An analysis of outcomes of reconstruction or amputation after leg-threatening injuries.

@article{Bosse2002AnAO,
  title={An analysis of outcomes of reconstruction or amputation after leg-threatening injuries.},
  author={Michael J Bosse and Ellen J. Mackenzie and James F. Kellam and Andrew R. Burgess and Lawrence Xavier Webb and Marc F Swiontkowski and Roy W. Sanders and Alan L. Jones and Mark P. McAndrew and Brendan M Patterson and Melissa Lee McCarthy and Thomas G Travison and Renan Carlos Castillo},
  journal={The New England journal of medicine},
  year={2002},
  volume={347 24},
  pages={
          1924-31
        }
}
BACKGROUND Limb salvage for severe trauma has replaced amputation as the primary treatment in many trauma centers. However, long-term outcomes after limb reconstruction or amputation have not been fully evaluated. METHODS We performed a multicenter, prospective, observational study to determine the functional outcomes of 569 patients with severe leg injuries resulting in reconstruction or amputation. The principal outcome measure was the Sickness Impact Profile, a multidimensional measure of… Expand

Paper Mentions

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ConditionsMusculoskeletal Injury
InterventionBehavioral
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TLDR
Avoiding residual limb infection is critically dependent on prompt amputation of non-salvageable limbs, and neither the nature of the injury nor pre-injury patient morbidity independently influenced residual limb infections. Expand
Limb salvage and amputation in Type 3C tibial fractures.
TLDR
Type 3C tibia fractures treated with both limb salvage and primary amputation have negative effects on quality of life and patients should be informed about limited functional capacity, pain complications and problems with return-to-work at the end of treatment. Expand
Is amputation a viable treatment option in lower extremity trauma?
TLDR
Early amputation seems to be better in cases of complications, despite similar quality of life in the two groups in the long-term, according to the Mangled Extremity Severity Score. Expand
Late amputation may not reduce complications or improve mental health in combat-related, lower extremity limb salvage patients.
TLDR
Surgeons caring for limb salvage patients should counsel appropriately when managing expectations for a patient who desires a late amputation, as Ongoing complications and mental health conditions can affect how a patient perceives and copes with his or her limb following severe trauma. Expand
Multiple High-Energy Open Injuries in the Same Limb: Comparison of Outcomes Between Salvage and Amputation Groups.
TLDR
Patients who had amputation returned to work earlier, had smaller number of secondary hospitalization and has less complications and incurred less expenditure for treatment. Expand
A meta-analysis of amputation versus limb salvage in mangled lower limb injuries--the patient perspective.
TLDR
The meta-analysis demonstrated that lower limb reconstruction is more acceptable psychologically to patients with severe lower limb trauma compared with amputation, even though the physical outcome for both management pathways was more or less the same. Expand
Outcomes of Amputations Versus Limb Salvages Following Military Lower Extremity Trauma
TLDR
Service members who undergo amputation appear to have better functional outcomes than those who undergo limb salvage, and had a lower likelihood of PTSD and a higher likelihood of being engaged in vigorous sports. Expand
Infectious complications and soft tissue injury contribute to late amputation after severe lower extremity trauma.
TLDR
Patients definitively managed with late amputation were more likely to have soft tissue injury requiring flap coverage and have their limb salvage course complicated by infection. Expand
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