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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2025, Number 5

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Acta Ortop Mex 2025; 39 (5)

Prescription pattern in the decision of early amputation of a severely injured limb in a referral trauma hospital

Gaytán-Fernández S, Aceves-Martínez M, Quiroz-Williams J, Barragan-Hervella R, Fernández-Rivera A, López-Meléndez L, Bautista-Martínez S, Cruz-Ricardez J

Language: Spanish
References: 29
Page: 292-298
PDF size: 330.05 Kb.


ABSTRACT

Introduction: the decision to amputate a severely injured limb is a dilemma for any orthopedic surgeon. There are multiple factors for this decision, being controversial for decision making. Objective: to know the type of prescription pattern for decision-making in early amputation of a severely injured limb in a reference trauma hospital. Material and methods: analytical, cross-sectional and prospective observational study. Orthopedic surgeons and resident physicians in the orthopedic specialty were evaluated, who evaluated five clinical cases of severely injured limbs, and through MESS, decided whether to amputate the limb. The statistic used was χ2 to assess the coincidence of the decisions with the experts' responses, and Odds Ratio to estimate risks. The value that was taken as statistically significant was p < 0.005. Results: sample 81 participants, 64.2% OB and 35.8% MR. The agreement of responses with the group of experts, OB was 85.4% and MR was 70%. In the OB, work experience had a higher percentage of coincidences, but they were not statistically significant (> 20 years, p = 0.034; 10-19 years, p = 0.011; < 9 years, p = 0.011) on the other hand, presenting a current certification (p = 0.002) and have a postgraduate degree after the specialty (p = 0.006) if they had one when compared with the responses of the group of experts. Conclusions: in all the physician surveyed, the correct application of MESS, they had a great agreement in the correct decision to save or amputate a severely damaged limb.


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EVIDENCE LEVEL

III




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