2010
DOI: 10.1302/0301-620x.92b11.23500
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Early or delayed limb lengthening after acute shortening in the treatment of traumatic below-knee amputations and Gustilo and Anderson type IIIC open tibial fractures

Abstract: We present the results of 13 patients who suffered severe injuries to the lower leg. Five sustained a traumatic amputation and eight a Gustilo-Anderson type IIIC open fracture. All were treated with debridement, acute shortening and stabilisation of the fracture and vascular reconstruction. Further treatment involved restoration of tibial length by callus distraction through the distal or proximal metaphysis, which was commenced soon after the soft tissues had healed (n = 8) or delayed until union of the fract… Show more

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Cited by 24 publications
(33 citation statements)
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References 19 publications
(25 reference statements)
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“…Conversion to a circular frame after the soft tissues have healed would have been an alternative which is more stable. Although referred to in the literature, we did not experience complications of pin loosening and secondary deformities in this patient or in our previous patients to whom we performed limb lengthening procedures with monolateral external fixators [1]. …”
Section: Discussionmentioning
confidence: 88%
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“…Conversion to a circular frame after the soft tissues have healed would have been an alternative which is more stable. Although referred to in the literature, we did not experience complications of pin loosening and secondary deformities in this patient or in our previous patients to whom we performed limb lengthening procedures with monolateral external fixators [1]. …”
Section: Discussionmentioning
confidence: 88%
“…Primary amputation is still a common choice in several centers but when the circulation of foot is reestablished and the sensation of the sole is preserved, limb-salvage procedures are an option. The total cost of the procedure may appear, after cursory assessment, to be three to four times that of amputation, but in fact, it is much more economical when the long-term outcome is considered [13]. …”
Section: Discussionmentioning
confidence: 99%
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“…Age was poorly reported and could be analysed in only 12 studies describing 577 patients. Four studies described a higher amputation rate among patients aged more than 55 years ( Figs and ).…”
Section: Resultsmentioning
confidence: 99%
“…A selection of studies, including some historical papers, reporting on outcomes in terms of amputation or salvage with grade IIIC fractures are shown in Table III. 1,2,9,16,25,[33][34][35][36][37] Most of the studies have combined data on IIIB and IIIC fractures; we have only included IIIC fractures from those studies.…”
Section: Discussionmentioning
confidence: 99%