[Treatment of severe injuries of the lower limbs. Identification of clinical criteria of severity].
The choice and timing of therapeutic methods for injuries of the lower limbs were evaluated in 60 patients. Primary amputation had to be performed in 18 of them, and conservative treatment was attempted in the others. Sixteen secondary amputations were necessary, mostly for arterial lesions. These results were not in agreement with the general severity of injury, as evaluated by the Injurity Severity Score. There was a significant difference in mortality depending on whether it was decided to amputate secondarily or to preserve the limb. When local signs of complication were present, this difference was highly significant. Age over 50 and arterial lesions were aggravating factors. When present together with an already high severity score, these factors should suggest immediate amputation as a life-saving measure.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D007869:Leg Injuries / Q000145:classification / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
Traitement des traumatismes graves des membres inférieurs. Individualisation de critères cliniques de gravité.