Amputation Or Reconstruction: Assesment of Long-term Outcome And Patient’s Satisfaction In Severe Lower Limb Trauma

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Author(s): Muhammad Osama, Tauqeer Hussain, Shehab Afzal Beg

Received: 19/10/2021 | Revised: 18/01/2022 | Published: 18/01/2022 | Pages: 12-18 | DOI: 10.6007/PJPS/v10-i1/3

Back ground: Complex and severe lower limb injuries pose a difficult situation for reconstructive surgeons. there is no consensus on the standard criteria to decide about amputation or limb salvage,

Objectives: Objective of the study was to compare the patient satisfaction in those undergoing amputation versus reconstruction in severe lower limb trauma. Methodology: Record of patients presenting to the accident and emergency department of Liaquat National Hospital, with limb threatening lower limb injuries during July 2016 to July 2018 were included. Patients were categorized in two groups; A) Patients who underwent primary amputation B) Patient who underwent salvage surgery. We reviewed the patients at least one year after the last procedure and assessment Performa (evaluating gait, skin and joint conditions and sensation) and patients’ satisfaction questionnaire were filled.

Results: Out of 50 patients that were included, 28 patients underwent primary amputation while 22 patients had limb salvage procedure. There was no significant difference in patients’ satisfaction in terms of pain, function, social activities and quality of life who under -went undergoing amputation or limb salvage.

Conclusion: A well planned and thoroughly judged primary amputation is a sensible option in certain cases with severe lower limb trauma(MESS score > 7) keeping in mind long-term patient’s morbidity and satisfaction.

Keywords | Salvage, primary amputation, reconstruction, Mangled Extremity severity score (MESS)