Outcomes After Severe Distal Tibia, Ankle, and/or Foot Trauma: Comparison of Limb Salvage Versus Transtibial Amputation (OUTLET).
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries. This study aims to build upon the previous work of the Lower Extremity Assessment Project by identifying the injury and patient characteristics that help define a subgroup of salvage patients who will have better outcomes had they undergone a transtibial amputation.
*Department of Orthopaedic Surgery, Carolinas Medical Center; †Department of Orthopaedic Surgery, University of Oklahoma College of Medicine; ‡Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health; §Department of Orthopaedic Surgery, McGovern Medical School at UTHealth Houston; ‖Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, University of California San Francisco; ¶Department of Orthopaedic Surgery, Naval Medical Center San Diego; **Department of Orthopaedic Surgery, Saint Louis University; ††Orthopaedic Trauma Service, Tampa General Hospital, Florida Orthopaedic Institute; and ‡‡Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health.
Michael J
MJ
Bosse
David
D
Teague
Lisa
L
Reider
Joshua L
JL
Gary
Saam
S
Morshed
Rachel B
RB
Seymour
James
J
Toledano
Lisa K
LK
Cannada
Barbara
B
Steverson
Daniel O
DO
Scharfstein
Jason
J
Luly
Ellen J
EJ
MacKenzie
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D016512:Ankle Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D018409:Foot Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013977:Tibia / Q000601:surgery; D013978:Tibial Fractures / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult