Acta Ortopédica Mexicana

Fernando Ruiz MF, Madrigal GR, Reyes-Gallardo A, Islas AA, Medina RF, Izquierdo HR, Vargas AA, Romero FMC, Barranco AR, Manrique PU, Sánchez M, Baliño CJ
Medical and economical impact produced by the amputation of a severely injured lower extremity. A comparison trial between early and late amputation
Acta Ortop Mex 2002; 16 (3)

Language: Español
References: 30
Page: 135-144
PDF: 60.77 Kb.

[Fulltext - PDF]

ABSTRACT

Objective. In order to help the surgeon to chose the most proper decision, in the present paper, medical complications and cost-benefits, are compared between patients in whom an early amputation has been performed and those in whom amputation was delayed after several atempts to reconstruction for salvage one severely injured lower extremity. Material and methods. A prospective and comparative trial was performed from January 1997 through October 2000, between 2 groups of 20 amputee patients each. Group I patients, 17 male and 3 female, age 43.9 years in average had an early amputation, most of them because of an IMSS class III-B open fracture. Group II patients, same gender rate, 35.7 years in avg., had a late amputation most of them because of an IMSS class III-A or III-C open fracture. Results. Main differences found between both groups were as follows: group I patients of early treatment had have an average of 2.15 operations prior to amputation, 11.6 days in hospital and a cost of treatment equivalent to US 6,809.01 dollars. Group II of late treatment had have an average of 5.2 operations before amputation, 31.1 days in hospital, systemic complications such as sepsis in 35% and the cost of treatment was the equivalent to US 15,122.00 dollars (p=0.006). Conclusion. Those patients who have an early amputation are more likely to carry on an outcome with less complications, as well as to incorporate to their labour and daily activities at a significant lower cost of treatment. It is important to emphasize that in the present paper a comparison is made just only between amputee patients. A major review of the literature is reported.


Key words: amputation, open fracture, severe, injury, costs.


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