BACKGROUND: Despite the impact of amputation for trauma has on the patients and the public health, a clear knowledge of postoperative complications frequency, reoperations rate and impacts on patient's life is still lacking. The aim of this study was to evaluate a 15-year case series of traumatic amputations. METHODS: Criteria of inclusion were major amputation of the lower limb in the last 16 years and minimum followup of one year. Age at trauma, sex, type of trauma, level of amputation, timing and revision surgeries were reviewed. Patients were evaluated regarding prosthesis use prosthesis usage, employment status, driving ability, pain (VAS), phantom limb pain (PLP) and long term-complications. RESULTS: Fifty-five patients compose the final cohort: 21 were amputated above knee (AKA), and 34 below knee (BKA). 57% of AKA and 71% of BKA were amputated immediately. All patients but one AKA use a prosthesis but only 55% of AKA patients and 76% of BKA patients uses it during all day. 38% of AKA works while 56% of BKA works. Only 33% of AKA and 26% of BKA drives. 53% suffer from chronic pain and/or PLP (mean VAS 6.2). PLP is more frequent and greater in AKA (66%) than BKA (44%). 62% of AKA and 65% of BKA needed revision surgery. Skin complications were for 57% of AKA and 71% of BKA. CONCLUSIONS: Amputated patients may benefit from a greater psychological assistance and social care in order to return to work and driving. Therefore, pain should be addressed.
Traumatic amputations of the lower limb: 15 years of experience
Bini N.;Aprato A.
;Caffa L.;Masse A.
2021-01-01
Abstract
BACKGROUND: Despite the impact of amputation for trauma has on the patients and the public health, a clear knowledge of postoperative complications frequency, reoperations rate and impacts on patient's life is still lacking. The aim of this study was to evaluate a 15-year case series of traumatic amputations. METHODS: Criteria of inclusion were major amputation of the lower limb in the last 16 years and minimum followup of one year. Age at trauma, sex, type of trauma, level of amputation, timing and revision surgeries were reviewed. Patients were evaluated regarding prosthesis use prosthesis usage, employment status, driving ability, pain (VAS), phantom limb pain (PLP) and long term-complications. RESULTS: Fifty-five patients compose the final cohort: 21 were amputated above knee (AKA), and 34 below knee (BKA). 57% of AKA and 71% of BKA were amputated immediately. All patients but one AKA use a prosthesis but only 55% of AKA patients and 76% of BKA patients uses it during all day. 38% of AKA works while 56% of BKA works. Only 33% of AKA and 26% of BKA drives. 53% suffer from chronic pain and/or PLP (mean VAS 6.2). PLP is more frequent and greater in AKA (66%) than BKA (44%). 62% of AKA and 65% of BKA needed revision surgery. Skin complications were for 57% of AKA and 71% of BKA. CONCLUSIONS: Amputated patients may benefit from a greater psychological assistance and social care in order to return to work and driving. Therefore, pain should be addressed.
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