Fibula Hemimelia: Amputation versus reconstruction systematic review and meta-analysis

Abstract

There is no universal agreement on the best course of action for treating lower limb abnormalities, which can be managed with either amputation or limb reconstruction. In patients with lower limb abnormalities, this meta-analysis compared patient satisfaction and surgical complications between amputation and limb reconstruction. A systematic search was done to find studies contrasting lower limb amputation and limb repair. MEDLINE, Cochrane Registry of Clinical Trials, EMBASE, PubMed, Google Scholar, CINAHL, and Elsevier Scopus databases was searched using keywords (amputation and reconstruction) AND (Fibula hemimelia OR Fibula deficit OR Fibular deformity) (therapy or treatment or management). Patient satisfaction and surgical complications were the main results. The odds ratio (OR) for patient satisfaction and the percentage of surgical problems per limb were calculated using a random-effects model. The meta-analysis includes seven trials that covered 202 patients in total. With an odds ratio of 6.8, patients who had limb amputations reported higher levels of treatment satisfaction than those who had limb reconstructions. Additionally, the odds ratio of 28 showed that the rate of surgical complications was much lower in the amputation group compared to the limb reconstruction group. In comparison to patients who underwent limb reconstruction, patients who had amputations reported higher levels of satisfaction and a lower risk of postoperative complications. According to these findings, amputation might be a better course of action for some patients with lower limb abnormalities.