title: Functional results of limb salvage in below-knee type III C open fractures or traumatic amputations.
abstract: This study presents the surgical and functional outcomes of below-knee total leg amputation and Gustilo type III C open fracture cases that were considered appropriate for salvage treatment according to a more proactive approach, despite being candidates for amputation according to the current scoring systems. Nineteen patients (21 legs) underwent replantation-revascularization surgery. At least Chen Grade II functional level was the aim. A limb salvage operation was performed in 21 legs in 19 patients (18 male, 1 female). The mean age was 28.5 years (range: 11 to 42 years). Six legs in four patients presented with total amputation, and 15 legs in 15 patients had Gustilo Type III C open fractures. A successful replantation/revascularization was performed in 20 legs, with a Chen Grade I and Grade II functional outcome in 3 and 17 legs, respectively. None of these patients were eligible for salvage operation according to currently used scoring systems. Limb-preserving surgery performed upon the assessment of local and general conditions of the patients with traumatic below-knee amputations or Gustilo Type III C open fractures seems to be a viable therapeutic option that can serve to achieve Chen Grade II functional level in most patients.
authors.affiliation: Department of Orthopedics, Yeni Yuzyil University, School of Medicine, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Parmaksizoglu
authors.forename: Mehmet Bekir
authors.initials: MB
authors.lastname: Unal
authors.forename: Eren
authors.initials: E
authors.lastname: Cansu
authors.forename: Ali Sefik
authors.initials: AS
authors.lastname: Koprulu
authors.forename: Yener
authors.initials: Y
authors.lastname: Ince
authors.forename: Ebru
authors.initials: E
authors.lastname: Yurga
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000673:Amputation, Traumatic / Q000601:surgery*; D002648:Child; D005260:Female; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D020127:Recovery of Function; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods