Long-term clinical outcomes of war-related hip disarticulation and transpelvic amputation

Ebrahimzadeh, Mohammad H.; Kachooei, Amir Reza; Moradi, Ali; Masoumi, Maryam

doi:10.5812/traumamon.28492

Cited by 13 publications

(23 citation statements)

References 22 publications

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“…14 Length and extent of the operation and surgical wound class were statistically significant variables that were associated with development of wound infection and flap necrosis. 12,21,22 One factor that has been shown to increase the risk for phantom pain and one of the most common chief complaints of patients undergoing hemipelvectomy is poorly controlled preoperative pain. 14 All types of soft tissue flaps have been shown to provide adequate immediate soft tissue coverage.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“…14 All types of soft tissue flaps have been shown to provide adequate immediate soft tissue coverage. 12 Residual limb spasm is a movement disorder (dyskinesia) that occurs weeks to months after amputation. 16 Phantom pain is frequently seen with hemipelvectomy-level amputation, with studies showing up to 90% of patients reporting phantom pain.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“…16 Phantom pain is frequently seen with hemipelvectomy-level amputation, with studies showing up to 90% of patients reporting phantom pain. 12,20 The incidence rate for both of these complications highlights the need for a multimodal pain and palliative care team for the treatment of both preoperative and postoperative pain. 22,23 Unlike phantom pain, residual limb spasm is more typically seen after traumatic amputation.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“…An external or standard hemipelvectomy is most often performed for tumors that cannot be adequately resected through limb-sparing techniques and to provide palliation for patients with pain or distress that cannot be managed with lesser means. 11,12 SURGICAL TECHNIQUE Hemipelvectomy-level amputation involves amputation of the lower extremity along with the hemipelvis. 11 Similarly, combat-related hemipelvectomy is generally indicated if there is insufficient soft tissue coverage after an injury to the proximal limb that is complicated by life-threatening local infection and/or a necrotic and dysvascular hemipelvis after early ligation of critical intrapelvic vasculature.…”

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confidence: 99%

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Hemipelvectomy

Houdek

Kralovec

Andrews

2014

American Journal of Physical Medicine &Amp; Rehabilitation

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The hemipelvectomy, most commonly performed for pelvic tumor resection, is one of the most technically demanding and invasive surgical procedures performed today. Adequate soft tissue coverage and wound complications after hemipelvectomy are important considerations. Rehabilitation after hemipelvectomy is optimally managed by a multidisciplinary integrated team. Understanding the functional outcomes for this population assists the rehabilitation team to counsel patients, plan goals, and determine discharge needs. The most important rehabilitation goal is the optimal restoration of the patient's functional independence. Factors such as age, sex, etiology, level of amputation, and general health play important roles in determining prosthetic use. The three main criteria for successful prosthetic rehabilitation of patients with high-level amputation are comfort, function, and cosmesis. Recent advances in hip and knee joints have contributed to increased function. Prosthetic use after hemipelvectomy improves balance and decreases the need for a gait aid. Using a prosthesis helps maintain muscle strength and tone, cardiovascular health, and functional mobility. With new advances in prosthetic components, patients are choosing to use their prostheses for primary mobility.

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Section: Postoperative Outcomesmentioning

confidence: 99%

Section: Postoperative Outcomesmentioning

confidence: 99%

Section: Postoperative Outcomesmentioning

confidence: 99%

mentioning

confidence: 99%

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Hemipelvectomy

Houdek

Kralovec

Andrews

2014

American Journal of Physical Medicine &Amp; Rehabilitation

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“…Numerous other factors contribute to a complicated rehabilitation and prosthesis fitting after hemipelvectomy or hip disarticulation including: medical comorbidities, obesity, and wound complications. Patients with transpelvic amputations benefit from lifelong care and surveillance by both their surgeon as well as a prosthetist that can ensure the prosthetic fits appropriately as the complex wound heals and body habitus changes with age [40].…”

Section: Pelvis and Hip Amputationsmentioning

confidence: 99%

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

Donegan¹

2017

ORP

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Long-term physical and psychological outcome following traumatic hemipelvectomy

Patrick

Krettek

Jennifer

et al. 2022

Eur J Trauma Emerg Surg

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Purpose First time examination of the physical and psychological long-term outcome following traumatic hemipelvectomy. Methodology In this study, all patients suffering from traumatic hemipelvectomy that were treated in a level-A trauma center since 1988 were retrospectively evaluated. The authors aimed to compare the physical and psychological outcome following primary amputation (A) vs. limb-preservation (LP) procedures. The patients were examined with a focus on pain, function, mobility and general health. As part of this examination, various scores were recorded, i.e., Majeed Score, Time up & Go or SF-36. Results The following work showed 13 patients who had suffered a traumatic hemipelvectomy, 8 of whom survived. Five of these were available for subsequent clinical re-examination; of these, three patients underwent an amputation, while limb preservation was performed on two patients. Mean follow-up of the amputee group was after 12 years compared to 6.5 years following limb preservation. After limb preservation, both patients reported phantom limb pain at the affected leg, despite pain medication. The general state of health was assessed as 82/100 (A) and 45/100 (LP). The Majeed score was 61 (A) vs. 45 (LP). In the clinical examination, three out of five patients (2 LP, 1 A) showed peroneal palsy (PP). In the quality-of-life analysis based on the SF12/36 and the NHP, amputees scored higher than the patients who underwent limb preservation surgery. Conclusion In our small patient cohort, satisfaction, pain and mobility tend to be better following primary amputation compared to limb preserving surgery.

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Long-term clinical outcomes of war-related hip disarticulation and transpelvic amputation

Cited by 13 publications

References 22 publications

Hemipelvectomy

Hemipelvectomy

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

Long-term physical and psychological outcome following traumatic hemipelvectomy

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