Bosse Michael J, Teague David, Reider Lisa, Gary Joshua L, Morshed Saam, Seymour Rachel B, Toledano James, Cannada Lisa K, Steverson Barbara, Scharfstein Daniel O, Luly Jason, MacKenzie Ellen J
*Department of Orthopaedic Surgery, Carolinas Medical Center; †Department of Orthopaedic Surgery, University of Oklahoma College of Medicine; ‡Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health; §Department of Orthopaedic Surgery, McGovern Medical School at UTHealth Houston; ‖Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, University of California San Francisco; ¶Department of Orthopaedic Surgery, Naval Medical Center San Diego; **Department of Orthopaedic Surgery, Saint Louis University; ††Orthopaedic Trauma Service, Tampa General Hospital, Florida Orthopaedic Institute; and ‡‡Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health.
J Orthop Trauma. 2017 Apr;31 Suppl 1:S48-S55. doi: 10.1097/BOT.0000000000000799.
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries. This study aims to build upon the previous work of the Lower Extremity Assessment Project by identifying the injury and patient characteristics that help define a subgroup of salvage patients who will have better outcomes had they undergone a transtibial amputation.
严重的足踝损伤治疗起来复杂且具有挑战性，通常需要多次手术来挽救肢体，这会导致愈合期延长。有证据表明，对于一些患者，早期截肢可能比保肢带来更好的长期预后。挑战在于确定个体的局部损伤负担，以提示截肢会有更好的预后。OUTLET研究是一项前瞻性、多中心观察性研究，比较了18 - 60岁患有严重胫骨远端、踝关节和足部损伤的患者保肢与早期截肢后18个月的预后。本研究旨在在前下肢评估项目的前期工作基础上，确定损伤和患者特征，以界定保肢患者中的一个亚组，这些患者若接受经胫骨截肢会有更好的预后。
