The mangled leg. Decision-making based on scoring systems and outcome

被引：1
作者：
Hoogendoorn J.M. [1 ]
Van der Werken C. [1 ]
机构：
[1] Department of Surgery, University Medical Center, Utrecht
来源：
European Journal of Trauma | 2002年 / 28卷 / 1期
关键词：
Decision-making; Predictive scoring systems; Quality of life; Severe limb injury; Short-term consequences;
D O I：
10.1007/s00068-002-1131-1
中图分类号：
学科分类号：
摘要：
A review of decision-making in the treatment of severe lower leg injuries is presented. In this article, several factors will be discussed which play a decisive role in the choice between an attempt at salvage and primary amputation. Based on these variables, predictive scoring systems have been proposed to objectify the regional injury severity of the limb in order to assist the surgeon in decision-making. The most widely described of these systems are compared. Furthermore, the short- and long-term consequences of treatment are discussed. Finally, a strategy for the treatment of mangled legs is proposed.
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页码：1 / 10
页数：9
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共 56 条
  • [1] Howe Jr. H.R., Poole Jr. G.V., Hansen K.J., Clark T., Plonk G.W., Koman L.A., Et al., Salvage of lower extremities following combined orthopedic and vascular trauma. A predictive salvage index, Am Surg, 53, pp. 205-208, (1987)
  • [2] Lange R.H., Bach A.W., Hansen S.V., Johansen K.H., Open tibial fractures with associated vascular injuries: Prognosis for limb salvage, J Trauma, 25, pp. 203-208, (1985)
  • [3] Drost T.F., Rosemurgy A.S., Proctor D., Kearney R.E., Outcome of treatment of combined orthopedic and arterial trauma of the lower extremity, J Trauma, 29, pp. 1331-1334, (1989)
  • [4] Francel T.J., Vander Kolk G.A., Hoopes J.E., Manson P.N., Yaremchuk M.J., Microvascular soft-tissue transplantation for reconstruction of acute open tibial fractures: Timing of coverage and long-term functional results, Plast Reconstr Surg, 89, pp. 478-487, (1992)
  • [5] Georgiadis G.M., Behrens F.F., Earle A.S., Simmons A.L., Open tibial fractures with severe soft-tissue loss, J Bone Joint Surg Am, 75, pp. 1431-1441, (1993)
  • [6] Hoogendoorn J.M., Van der Werken C., Grade III open tiblal fractures. Functional outcome and quality of life in amputees versus patients with succesful reconstruction, Injury, 42, pp. 329-334, (2001)
  • [7] Gustilo R.B., Anderson J.T., Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: Retrospective and prospective analyses, J Bone Joint Surg Am, 58, pp. 453-458, (1976)
  • [8] Gustilo R.B., Mendoza R.M., Williams D.N., Problems in the management of type III severe open fractures: A new classification of type III open fractures, J Trauma, 24, pp. 742-746, (1984)
  • [9] Brumback R.J., Jones A.L., Interobserver agreement in the classification of open fractures of the tibia. The results of a survey of two hundred and forty-five orthopaedic surgeons, J Bone Joint Surg Am, 76, pp. 1162-1166, (1994)
  • [10] Muller M.E., Nazarian S., Koch P., Schatzker J., The comprehensive classification of fractures of long bones, (1990)
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