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Biomechatronics Group, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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traumatic lower-limb amputees need to have revision surgery, 5 and 25–56% of amputees develop social problems. Age-adjusted rates of lower-extremity amputations are in the range of 16.9–22.9 amputees/100,000 inhabitants/year in different countries
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and burning sensations. Amputation Primary amputation may be considered in cases of uncontrollable haemorrhage, prolonged crush injury, an avascular limb or segmental bone/muscle loss. The decision is not taken lightly and should be discussed
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69% of the cases. 2 Associated fractures can be present in 44% of patients. 9 The death rate on admission can be up to 10%. 10 - 12 Popliteal artery lesions and/or severe open fractures and mangled limbs can lead to amputation in 9
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. Any discrepancies between the investigators (MK/VG) were referred to a third investigator for arbitration (BvD). Full texts of articles meeting the inclusion criteria were obtained. All studies related to limb amputation in the upper/lower extremity
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the decision-making ( 14 , 16 ). The decision to amputate or to preserve the limb in cases of severe injury should be made as an individual decision. In rare cases and in extremely severe injuries, amputation may be recommended ( 33 ). In addition
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Motorcycle thumb Collision Pelvic ring Fuel tank injuries Collision Lower extremity: femur, tibia, fibula Limb entrapment Lowside Lower extremity: heel Tyre-spoke injury Lowside Lower extremity: foot Crash modifying
School of Medicine, Universidad de La Laguna, Tenerife, Spain
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School of Medicine, Universidad de La Laguna, Tenerife, Spain
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University of Basel, Basel, Switzerland
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School of Medicine, Universidad de Sevilla, Sevilla, Spain
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preference. AKA, above-knee amputation; ASA, Functional score from the American Society of Anaesthesiology; BKA, below-knee amputation; DVT, deep vein thrombosis; FU, follow-up; LOE, level of evidence; Nr, non reported; NWB, Non-weight-bearing; ORIF
King’s Global Health Partnerships, School of Life Course and Population Sciences, King’s College London, London, UK
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Department of Orthopaedics, University of the Philippines, Philippine General Hospital Manila, The Phillipines
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include internal and external fixation for fractures (open or closed) and amputation ( 8 ). Injuries cause more than 5 million deaths per year ( 9 ) and it is estimated that 88% of injury-related deaths occur in LMICs ( 10 ). For every death, between 10
Department of Orthopaedics and Traumatology, Freiburg University Hospital, Freiburg, Germany.
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swelling, and improvement of function. For a minority of patients this might mean that an amputation or a ‘stable’ nonunion with acceptable pain level might be an option. For most patients an operative revision is indicated and required when progress in
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screw breakage or cutout; 2 superficial wound infection; 1 deep vein thrombosis Swentik et al. (25) 8/10 (80%) (excluding the one with knee amputation) patients had healed fracture without repeated operations; 1 required revision stabilization