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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
1   Department of Orthopedics, Yeni Yuzyil University, School of Medicine, Istanbul, Turkey
,
Mehmet Bekir Unal
2   Department of Orthopedics, Medipol Hospital, Istanbul, Turkey
,
Eren Cansu
3   Department of Orthopedics, Marmara University, School of Medicine, Istanbul, Turkey
,
Ali Sefik Koprulu
4   Department of Anesthesiology and Intensive Care, Yeni Yuzyil University, School of Medicine, Istanbul, Turkey
,
Yener Ince
5   Department of Orthopedics, Camlica Alman Hospital, Istanbul, Turkey
,
Ebru Yurga
6   LifeMed Outpatient Clinic, Istanbul, Turkey
› Author Affiliations
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Publication History

16 January 2012

25 April 2012

Publication Date:
21 September 2012 (online)

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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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