Medium-term outcomes following limb salvage for severe XXXX are similar to trans-tibial amputation.

@entity1 @entity158 @entity130 @entity4422
UNASSIGNED: @entity130 define the surgical burden of recent conflicts. Current literature is inconclusive when assessing the merits of limb salvage over amputation. The aim of this study was to determine medium term functional outcomes in military casualties undergoing limb salvage for severe @entity4422 , and compare them to equivalent outcomes for unilateral trans-tibial amputees. Cases of severe open diaphyseal tibia fractures sustained in combat between 2006 and 2010, as described in a previously published series, were contacted. Consenting individuals conducted a brief telephone interview and were asked to complete a SF-36 questionnaire. These results were compared to a similar cohort of 18 military @entity1 who sustained a unilateral trans-tibial amputation between 2004 and 2010. Forty-nine @entity1 with 57 severe @entity4422 met the inclusion criteria. Telephone follow-up and SF-36 questionnaire data was available for 30 @entity1 (61%). The median follow-up was 4 years (49 months, IQR 39-63). Ten of the 30 @entity1 required revision surgery, three of which involved conversion from initial fixation to a circular frame for non- or mal-union. Twenty-two of the 30 @entity1 (73%) recovered sufficiently to complete an age-standardised basic military fitness test. The median physical component score of SF-36 in the limb salvage group was 46 (IQR 35-54) which was similar to the trans-tibial amputation cohort (p=0.3057, Mann-Whitney). Similarly there was no difference in mental component scores between the limb salvage and amputation groups (p=0.1595, Mann-Whitney). There was no significant difference in the proportion of @entity1 in either the amputation or limb salvage group reporting @entity158 (p=0.1157, Fisher's exact test) or with respect to SF-36 physical @entity158 scores (p=0.5258, Mann-Whitney). This study demonstrates that medium term outcomes for military @entity1 are similar following trans-tibial amputation or limb salvage following combat @entity130 .
