title: Total and subtotal amputation of lower limbs treated by acute shortening, revascularization and early limb lengthening with ilizarov ring fixation - a retrospective study.
abstract: We present the results of 15 patients who sustained total or subtotal traumatic amputation of the lower limbs who were treated by acute limb shortening and stabilisation with external fixator, revascularization and early lengthening with Ilizarov ring fixator. The mean age of the patients was 28 years [5-38]. There were three females and 12 males. The mean Mangled Extremity Severity Score was 8.5 [range 6-11]. The mean amount of shortening done was 6.9cm [range 3-12.5] to enable revascularization and soft tissue repair. Three cases had to be amputated early because of failure of vascular repair. In the remaining 12 patients who were followed up the mean interval between revascularization and application of Ilizarov ring fixator was 4.7 weeks [range 3-10]. The mean follow up was 6.5 years [3-16 years]. Union occurred in all patients. Ten of the 12 patients returned to work and residual shortening was present in two cases. We conclude that whenever possible lower limb salvage should be undertaken.
authors.affiliation: Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India. Electronic address: kovoor63@gmail.com.
authors.forename: C C
authors.initials: CC
authors.lastname: Kovoor
authors.affiliation: Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India.
authors.forename: V V
authors.initials: VV
authors.lastname: George
authors.affiliation: Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India.
authors.forename: R
authors.initials: R
authors.lastname: Jayakumar
authors.affiliation: Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India.
authors.forename: A J
authors.initials: AJ
authors.lastname: Guild
authors.affiliation: Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India.
authors.forename: D
authors.initials: D
authors.lastname: Bhaskar
authors.affiliation: Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India.
authors.forename: A
authors.initials: A
authors.lastname: Cyriac
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005260:Female; D017102:Fracture Healing; D006801:Humans; D018889:Ilizarov Technique; D007194:India / Q000453:epidemiology; D007870:Leg Length Inequality / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D015599:Trauma Severity Indices; D016896:Treatment Outcome
keywords: Amputation; Ilizarov external fixator; Lower limb; Revascularization lengthening; Shortening