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