Adegbehingbe O O, Akinyoola A L, Oginni L M
Department of Orthopaedic Surgery and Traumatology, College of Health Sciences, Obafemi Awolowo University, Ile-ife, Nigeria.
East Afr Med J. 2006 Oct;83(10):539-44. doi: 10.4314/eamj.v83i10.9466.
The decision to attempt salvage or to amputate a severely injured limb is among the most difficult decision that the orthopaedist must face.
To determine possible predictive factors that could become guides in taking decision for primary amputation as a first line treatment for trauma patients.
A prospective study of post-traumatic primary limb amputations.
The Obafemi Awolowo University Teaching Hospital Ile-Ife, Nigeria from January, 2000 to December, 2004.
Sixty six trauma patients admitted through the Accident and Emergency Unit from January 2000 to December 2004.
Sixty six traumatised patient limbs were primarily amputated during the study period. The male: female ratio was 3.7:1 and means age was 28.6 years +/- 16.6(range: 4-71 years). 80.3% of the patients were below forty years. All the patients had a single limb amputation. The mean MESS score was 9.4 +/- 1.3 (range: 7.0-12.0). The main predictive factors in trauma at the emergency unit for primary amputation include age, sex, occupation, limb ischaemia, gangrene, severe open fracture, source or nature of injury, presence of shock, delay in hospital presentation, and MESS.
Immediate amputation is often viewed by the patient and family as a result of the injury. Conversely, a delayed amputation may be viewed as a failure of treatment. Identified predictive factors for primary amputation will reduce trauma associated morbidity and mortality.
决定对严重受伤的肢体进行挽救还是截肢，是骨科医生必须面对的最艰难的决定之一。
确定可能的预测因素，这些因素可作为指导，为创伤患者的一线治疗做出初次截肢的决定。
一项关于创伤后初次肢体截肢的前瞻性研究。
尼日利亚伊费奥巴费米·阿沃洛沃大学教学医院，时间为2000年1月至2004年12月。
2000年1月至2004年12月通过急诊室收治的66例创伤患者。
在研究期间，66例创伤患者的肢体被进行了初次截肢。男女比例为3.7:1，平均年龄为28.6岁±16.6岁（范围：4 - 71岁）。80.3%的患者年龄在40岁以下。所有患者均为单肢截肢。平均MESS评分为9.4±1.3（范围：7.0 - 12.0）。急诊室创伤患者初次截肢的主要预测因素包括年龄、性别、职业、肢体缺血、坏疽、严重开放性骨折、损伤来源或性质、休克的存在、入院延迟以及MESS评分。
患者及其家属通常认为立即截肢是由损伤导致的。相反，延迟截肢可能被视为治疗失败。确定的初次截肢预测因素将降低创伤相关的发病率和死亡率。
