From the Department of Surgery, Shohada Medical Center, Sizahid Beheshti University of Medical Sciences,
Abstract: (5389 Views)
The objective of this report is to prove that even after development of
ischemic necrosis of the muscles and nerves, we can still save the extremity
or the knee and even several days after arterial injury, perform arterial
repair and other mentioned procedures. Thus we can retain a functionally
satisfactory leg or knee joint, which is far better than classic above-knee
amputation and utilization of an artificial leg.
28 cases have been chosen in this series, and arterial repair was
performed 24 to 72 hours after arterial injury. The arterial injuries were at
or above knee level, all the muscles of the leg were found to be necrotic at
the time of arrival, and the leg was senseless below the knee or mid-shin.
23 cases underwent leg salvage, and in five who had fractured tibia or
necrosis of the skin of the sole or around the ankle, mid-shaft amputation
with knee salvage was performed, rather than above-knee amputation.
Only three unsuccessful results were encountered, which the authors feel
were due to improper case selection, and one mortality was reported, due
to pulmonary embolism.
The comparative results were far better than above-knee amputation,
both in below-knee amputation and leg salvage, and the patients did not
consider themelves disabled either physically or mentally. With proper
care, the patients were able to lead completely normal lives with no job
opportunity limitations. The authors conclude that even several days after
arterial injury and despite ischemic necrosis of muscles and nerves, lower
limb or knee salvage is still possible, and classic "a-k"amputation is not
the only alternative.
Type of Study:
Original Research |
Subject:
Surgery