Amputation as a salvage for patients with incapacitating infected fractures of the lower limbs.

Abstract

Most serious lower-limb injuries with severe bone and soft tissue damage heal when treated wisely by techniques available today. Unfortunately, a small percentage of patients face prolonged physical and economic disability as a result of extensive damage to bone and soft tissue, nonunion of fractures with infection, nerve and blood-vessel injury, and complications of surgical treatment. Every effort should be made to effect union by established methods but a small percentage of fractures do not heal satisfactorily. Failure of infected lower-limb fractures to unite after prolonged treatment or the prospect of prolonged treatment or the prospect of prolonged morbidity and disability occasionally justify amputation in one lower limb. When a lower-limb prosthesis can provide stability support, and mobility painlessly, and overcome the morbidity and disability of an infected ununited fracture, amputation may be the treatment of choice. In the present review of our experiences in the past 17 years with patients having severly injured and diseased lower limbs where little chance existed for rehabilitation to acceptable levels of function by various methods of treatment, open amputation through infected bone followed by secondary closure was chosen to salvage the unfortunate patient with littlw chance of achieving acceptable function after infected ununited fractures of the lower limbs.