Amputation for a mangled extremity is an effective and reliable life-saving treatment method, which requires a relatively shorter duration for treatment than limb salvage. However, only a few studies have focused on treatment with amputation. Herein, we report good clinical outcomes achieved through staged surgery performed after amputation.
Materials and methods
This study included 47 patients (38 men, 9 women; average age, 52.4 years) diagnosed with mangled extremity, who underwent primary amputation between March 2014 and January 2019. The patients were divided into the initial closure (IC) groups (including 26 patients who underwent IC after amputation) and staged surgery (SS) (including 21 patients who underwent SS after amputation) groups. The presence of complications including necrosis and infection, consequent additional surgery, duration of hospitalization and expense for treatment, and functional scores of upper and lower extremities were assessed.
No specific postoperative complication was found in the SS group. However, additional surgeries were performed in the IC group because of complications including three cases of infection and two cases of necrosis. The differences between the hospitalization period, treatment cost, and functional examination conducted 1 year after surgery of the two groups were not statistically significant. The patients in the IC group who underwent additional surgery were hospitalized for a longer period and presented with lower functional scores due to delayed rehabilitation.
Staged surgery is a definitive and safe treatment option that can effectively reduce complications including infection and necrosis in patients with mangled extremity.
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The study did not receive funding from any source.
Conflict of interest
The authors declare that they have no conflict of interest.
The study design and data collection were approved by the institutional review board of the Human Experimental and Ethics Committee of our hospital.
Informed consent was obtained from all individual participants and/or their families.
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Yoon, YC., Oh, CW., Jang, M.J. et al. Clinical outcome of staged surgery after primary amputation for mangled extremity. Arch Orthop Trauma Surg 141, 411–417 (2021). https://doi.org/10.1007/s00402-020-03497-1
- Mangled extremity
- Staged surgery