title: Gritti-stokes amputations in the trauma patient: clinical comparisons and subjective outcomes.
abstract: BACKGROUND
  The Gritti-Stokes amputation procedure is a modification of the traditional transfemoral amputation, with resection of the bone at a supracondylar femoral level and fixation of the patella to the distal part of the femur as an end-cap. Although well-established in patients with vascular compromise, no evidence exists on its use in the trauma setting.
  
  
  METHODS
  Fourteen consecutive patients who underwent Gritti-Stokes amputation and fifteen consecutive patients who underwent traditional transfemoral amputation by fellowship-trained orthopaedic traumatologists at a level-I trauma center were evaluated at more than fourteen months postoperatively. The Sickness Impact Profile (SIP) questionnaire was also administered to both patient groups at more than thirty-six months postoperatively to assess patient-reported functional outcomes.
  
  
  RESULTS
  Despite the two groups not having significant differences in preoperative variables or demographics, the Gritti-Stokes group had significantly improved SIP questionnaire overall and domain scores. This procedure also left the patients with a significantly longer residual limb (an average of 46.1 cm of residual femoral length versus 34.6 cm for the transfemoral group). The Gritti-Stokes group also had a significantly increased rate of walking without assistive devices (five patients versus none in the transfemoral amputation group).
  
  
  CONCLUSIONS
  The Gritti-Stokes amputation appears to be safe and beneficial when utilized in the trauma population.
authors.affiliation: Department of Orthopedic Surgery, Grant Medical Center, 285 East State Street, Suite 500, Columbus, OH 43215, USA. drbentaylor@gmail.com
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Taylor
authors.forename: Attila
authors.initials: A
authors.lastname: Poka
authors.forename: Bruce G
authors.initials: BG
authors.lastname: French
authors.forename: T Ty
authors.initials: TT
authors.lastname: Fowler
authors.forename: Sanjay
authors.initials: S
authors.lastname: Mehta
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D001186:Artificial Limbs; D016063:Blood Loss, Surgical; D015331:Cohort Studies; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000503:physiopathology*; D010329:Patella / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods; D012042:Registries; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D055815:Young Adult