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Amputation for open lower-limb fractures should not be seen as a failure

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PRAGUE — Amputation of a limb as a result of an open fracture should not be considered a failure by the patient or medical team, as functional outcomes and quality of life can be better than that achieved with conservative treatment, according to a presenter at the 16th EFORT Congress.

“We believe amputation brings rapid functional recovery, less complications, less hospitalization duration and best quality-of-life results,” Monique Fioravanti, MD, said during a presentation, here. “It should not be considered as a failure by the medical team and the patient. It should be considered as a real treatment.”

Fioravanti and colleagues compared functional and quality-of-life outcomes between patients who underwent amputation and those who underwent conservative treatment for open lower-limb fractures (Gustilo IIIB/IIIC). A total of 30 patients were included in the retrospective study, with 15 included in the amputation cohort and 15 in the conservative treatment cohort.

Monique Fioravanti

According to Fioravanti, patients receiving conservative treatment spent twice as long in the hospital (10.4 weeks vs. 5.6 weeks), had 2.5-times more surgeries (4.9 vs. 2) and twice as many infections when compared with those in the amputation group.

Amputation patients had a better global quality-of-life (SF-36 Medical Outcomes Study) scores in all categories except for mental health and general health perception scores. Fioravanti said 14 out of 15 amputation patients regained the ability to drive, compared with just 10 out of 15 of the conservative treatment patients.

Fioravanti also noted amputation patients had better walking distance, stair-climbing ability, return to sports and running outcomes compared with conservative treatment patients. There was also no statistically significant difference for professional activity recovery, she said. – by Robert Linnehan

Reference: Fioravanti M. Amputation versus conservative treatment in open lower limb fractures (Gustilo IIIB/IIIC): a functional and a quality-of-life study. Presented at: 16th EFORT Congress; May 27-29 2015; Prague.

Disclosure: Fioravanti reports no relevant financial disclosures.