Functional Results of Limb Salvage in Below-Knee Type III C Open Fractures or Traumatic Amputations

Fatih Parmaksizoglu; Mehmet Bekir Unal; Eren Cansu; Ali Sefik Koprulu; Yener Ince; Ebru Yurga

doi:10.1055/s-0032-1326735

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2012; 28(09): 607-614
DOI: 10.1055/s-0032-1326735

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Functional Results of Limb Salvage in Below-Knee Type III C Open Fractures or Traumatic Amputations

Fatih Parmaksizoglu

¹Department of Orthopedics, Yeni Yuzyil University, School of Medicine, Istanbul, Turkey

,

Mehmet Bekir Unal

²Department of Orthopedics, Medipol Hospital, Istanbul, Turkey

,

Eren Cansu

³Department of Orthopedics, Marmara University, School of Medicine, Istanbul, Turkey

,

Ali Sefik Koprulu

⁴Department of Anesthesiology and Intensive Care, Yeni Yuzyil University, School of Medicine, Istanbul, Turkey

,

Yener Ince

⁵Department of Orthopedics, Camlica Alman Hospital, Istanbul, Turkey

,

Ebru Yurga

⁶LifeMed Outpatient Clinic, Istanbul, Turkey

› Author Affiliations

Abstract

This study presents the surgical and functional outcomes of below-knee total leg amputation and Gustilo type III C open fracture cases that were considered appropriate for salvage treatment according to a more proactive approach, despite being candidates for amputation according to the current scoring systems. Nineteen patients (21 legs) underwent replantation-revascularization surgery. At least Chen Grade II functional level was the aim. A limb salvage operation was performed in 21 legs in 19 patients (18 male, 1 female). The mean age was 28.5 years (range: 11 to 42 years). Six legs in four patients presented with total amputation, and 15 legs in 15 patients had Gustilo Type III C open fractures. A successful replantation/revascularization was performed in 20 legs, with a Chen Grade I and Grade II functional outcome in 3 and 17 legs, respectively. None of these patients were eligible for salvage operation according to currently used scoring systems. Limb-preserving surgery performed upon the assessment of local and general conditions of the patients with traumatic below-knee amputations or Gustilo Type III C open fractures seems to be a viable therapeutic option that can serve to achieve Chen Grade II functional level in most patients.

Keywords

total leg amputation - Gustilo type III C open fracture - limb salvage

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References

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