Amputation versus conservative treatment in severe open lower-limb fracture: A functional and quality-of-life study
Severe lower-limb trauma is a major event in a patient's life, and treatment is a challenge that has not been sufficiently studied. The main objective of the present study was to assess the difference in disability between amputees and patients who kept their leg after severe open lower-limb fr...
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| Veröffentlicht in: | Orthopaedics & traumatology, surgery & research surgery & research, 2018-04, Vol.104 (2), p.277-281 |
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| creator | Fioravanti, M. Maman, P. Curvale, G. Rochwerger, A. Mattei, J.-C. |
| description | Severe lower-limb trauma is a major event in a patient's life, and treatment is a challenge that has not been sufficiently studied. The main objective of the present study was to assess the difference in disability between amputees and patients who kept their leg after severe open lower-limb fracture.
The study hypothesis was that amputation allows better functional recovery and quality of life, in the same time-frame.
All male and female patients aged over 18 years admitted to one of the trauma centers of Marseille (France) for major lower-limb trauma with Gustilo IIIb or IIIc fracture were included. Minimum follow-up was 2 years. Two groups were distinguished according to primary treatment: lower-limb salvage, or amputation. Rates of infection and of surgical revision, hospital stay, functional parameters (walking distance, standing, use of canes, running, jumping, driving, and physical and occupational activity) and quality of life (MOS SF-36 score) were compared between groups.
The conservative treatment group comprised 27 patients, and the amputation group 24. Rates of infection and of surgical revision and hospital stay were significantly lower in the amputation group (P |
| doi_str_mv | 10.1016/j.otsr.2017.12.013 |
| format | Article |
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The study hypothesis was that amputation allows better functional recovery and quality of life, in the same time-frame.
All male and female patients aged over 18 years admitted to one of the trauma centers of Marseille (France) for major lower-limb trauma with Gustilo IIIb or IIIc fracture were included. Minimum follow-up was 2 years. Two groups were distinguished according to primary treatment: lower-limb salvage, or amputation. Rates of infection and of surgical revision, hospital stay, functional parameters (walking distance, standing, use of canes, running, jumping, driving, and physical and occupational activity) and quality of life (MOS SF-36 score) were compared between groups.
The conservative treatment group comprised 27 patients, and the amputation group 24. Rates of infection and of surgical revision and hospital stay were significantly lower in the amputation group (P<0.02). All functional parameters (except return to work) and overall quality of life were significantly better in the amputation group. There was no significant inter-group difference in MOS mental score.
In severe lower-limb trauma, amputation seems to give better functional and quality-of-life results. It did not, however, improve return to work, and was not better accepted psychologically than long and complex conservative management.
IV, retrospective study.</description><identifier>ISSN: 1877-0568</identifier><identifier>EISSN: 1877-0568</identifier><identifier>DOI: 10.1016/j.otsr.2017.12.013</identifier><identifier>PMID: 29407071</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Amputation ; Complications ; Conservative treatment ; Disability ; Functional outcome ; Lower limb ; MOS SF-36 ; Open fracture ; Quality of life ; Severity</subject><ispartof>Orthopaedics & traumatology, surgery & research, 2018-04, Vol.104 (2), p.277-281</ispartof><rights>2018 Elsevier Masson SAS</rights><rights>Copyright © 2018 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-58d7113037fd75464a4bb3e05f74e4a6b2d313d5277ee1c7a58c82c66441ef723</citedby><cites>FETCH-LOGICAL-c400t-58d7113037fd75464a4bb3e05f74e4a6b2d313d5277ee1c7a58c82c66441ef723</cites><orcidid>0000-0002-6260-3267</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S187705681830032X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29407071$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fioravanti, M.</creatorcontrib><creatorcontrib>Maman, P.</creatorcontrib><creatorcontrib>Curvale, G.</creatorcontrib><creatorcontrib>Rochwerger, A.</creatorcontrib><creatorcontrib>Mattei, J.-C.</creatorcontrib><title>Amputation versus conservative treatment in severe open lower-limb fracture: A functional and quality-of-life study</title><title>Orthopaedics & traumatology, surgery & research</title><addtitle>Orthop Traumatol Surg Res</addtitle><description>Severe lower-limb trauma is a major event in a patient's life, and treatment is a challenge that has not been sufficiently studied. The main objective of the present study was to assess the difference in disability between amputees and patients who kept their leg after severe open lower-limb fracture.
The study hypothesis was that amputation allows better functional recovery and quality of life, in the same time-frame.
All male and female patients aged over 18 years admitted to one of the trauma centers of Marseille (France) for major lower-limb trauma with Gustilo IIIb or IIIc fracture were included. Minimum follow-up was 2 years. Two groups were distinguished according to primary treatment: lower-limb salvage, or amputation. Rates of infection and of surgical revision, hospital stay, functional parameters (walking distance, standing, use of canes, running, jumping, driving, and physical and occupational activity) and quality of life (MOS SF-36 score) were compared between groups.
The conservative treatment group comprised 27 patients, and the amputation group 24. Rates of infection and of surgical revision and hospital stay were significantly lower in the amputation group (P<0.02). All functional parameters (except return to work) and overall quality of life were significantly better in the amputation group. There was no significant inter-group difference in MOS mental score.
In severe lower-limb trauma, amputation seems to give better functional and quality-of-life results. It did not, however, improve return to work, and was not better accepted psychologically than long and complex conservative management.
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The study hypothesis was that amputation allows better functional recovery and quality of life, in the same time-frame.
All male and female patients aged over 18 years admitted to one of the trauma centers of Marseille (France) for major lower-limb trauma with Gustilo IIIb or IIIc fracture were included. Minimum follow-up was 2 years. Two groups were distinguished according to primary treatment: lower-limb salvage, or amputation. Rates of infection and of surgical revision, hospital stay, functional parameters (walking distance, standing, use of canes, running, jumping, driving, and physical and occupational activity) and quality of life (MOS SF-36 score) were compared between groups.
The conservative treatment group comprised 27 patients, and the amputation group 24. Rates of infection and of surgical revision and hospital stay were significantly lower in the amputation group (P<0.02). All functional parameters (except return to work) and overall quality of life were significantly better in the amputation group. There was no significant inter-group difference in MOS mental score.
In severe lower-limb trauma, amputation seems to give better functional and quality-of-life results. It did not, however, improve return to work, and was not better accepted psychologically than long and complex conservative management.
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| source | Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Amputation Complications Conservative treatment Disability Functional outcome Lower limb MOS SF-36 Open fracture Quality of life Severity |
| title | Amputation versus conservative treatment in severe open lower-limb fracture: A functional and quality-of-life study |
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