The mangled foot and leg: salvage versus amputation.
Determining whether to perform limb salvage or amputation in the traumatized lower extremity continues to be a difficult problem in the military and civilian sectors. Numerous predictive scores and models have failed to provide definitive criteria for prediction of limb-salvage success. Excellent support is available in the military health care system for soldiers electing to undergo either limb salvage or amputation. Recent experience with soldiers who sustained limb-threatening injuries has shown that delayed amputation after limb-salvage attempts is a viable option for soldiers wounded in combat.
Shawen
Scott B
SB
Orthopaedic Foot and Ankle Service, Walter Reed Army Medical Center (WRAMC), Washington, DC 20307, USA. scott.shawen@us.army.mil
Keeling
John J
JJ
Branstetter
Joanna
J
Kirk
Kevin L
KL
Ficke
James R
JR
D000671:Amputation, Surgical / Q000379:methods*; D001753:Blast Injuries / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005592:Fracture Fixation / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D015601:Injury Severity Score; D007869:Leg Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008887:Military Medicine / Q000379:methods; D008889:Military Personnel; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D018570:Risk Assessment; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014857:Warfare; D014945:Wound Healing / Q000502:physiology