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Amputation rate following tibia fractures with associated popliteal artery injuries
Objectives: 1. Determine the amputation rate; and 2. identify risk factors in patients with tibia fractures and associated popliteal artery injuries. Intervention: Amputation or limb salvage. Design: Retrospective case-control study. Setting: Level 1 trauma center. Patients: Thirty popliteal artery...
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| Format: | Thesis |
| Language: | English |
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Department of Health and Rehabilitation Sciences
2017
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| _version_ | 1867613177057902593 |
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| access_status_str | Open Access |
| author | Roussot, Mark |
| author2 | Maqungo, Sithombo |
| author_browse | Maqungo, Sithombo Roussot, Mark |
| author_facet | Maqungo, Sithombo Roussot, Mark |
| author_sort | Roussot, Mark |
| collection | Thesis |
| description | Objectives: 1. Determine the amputation rate; and 2. identify risk factors in patients with tibia fractures and associated popliteal artery injuries. Intervention: Amputation or limb salvage. Design: Retrospective case-control study. Setting: Level 1 trauma center. Patients: Thirty popliteal artery injuries with ipsilateral tibial fractures. Outcome measures: Primary and delayed amputation rates were determined. Risk factors tested for significance (Fischer's Exact) included: mechanism of injury, signs of threatened viability, compartment syndrome, fracture pattern, surgical sequence, and time delay from injury or presentation to revascularization. Results: The study group consisted of 22 males and 8 females, with a mean age of 31 years. Motor vehicle accidents and gunshot wounds constituted the mechanism in 17 and 11 patients respectively. Twenty-one were polytrauma victims. Intra/extra16 articular metaphyseal fractures (OTA 41 A-C) were recorded in 19 and diaphyseal (OTA 42 A-C) in 7 patients. Primary amputation was performed in 7 and delayed in 10 patients (overall rate 57%). No individual risk factors were predictive of amputation; however, the "miserable triad" of a proximal tibia fracture (OTA 41) with signs of threatened viability, and delay to revascularization ≥ 6 hours from injury or ≥ 2 hours from presentation was predictive of amputation (p = 0,036 and p = 0,018 respectively). Conclusions: We should aim to intervene within 6 hours following injury or 2 hours following presentation to reduce the risk of amputation. This provides a target for trauma teams even with uncertain time of injury. Level of Evidence: III. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/25507 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:31:58.458Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Department of Health and Rehabilitation Sciences |
| publisherStr | Department of Health and Rehabilitation Sciences |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/25507 Amputation rate following tibia fractures with associated popliteal artery injuries Roussot, Mark Maqungo, Sithombo Roche, Stephen Orthopaedic Surgery Objectives: 1. Determine the amputation rate; and 2. identify risk factors in patients with tibia fractures and associated popliteal artery injuries. Intervention: Amputation or limb salvage. Design: Retrospective case-control study. Setting: Level 1 trauma center. Patients: Thirty popliteal artery injuries with ipsilateral tibial fractures. Outcome measures: Primary and delayed amputation rates were determined. Risk factors tested for significance (Fischer's Exact) included: mechanism of injury, signs of threatened viability, compartment syndrome, fracture pattern, surgical sequence, and time delay from injury or presentation to revascularization. Results: The study group consisted of 22 males and 8 females, with a mean age of 31 years. Motor vehicle accidents and gunshot wounds constituted the mechanism in 17 and 11 patients respectively. Twenty-one were polytrauma victims. Intra/extra16 articular metaphyseal fractures (OTA 41 A-C) were recorded in 19 and diaphyseal (OTA 42 A-C) in 7 patients. Primary amputation was performed in 7 and delayed in 10 patients (overall rate 57%). No individual risk factors were predictive of amputation; however, the "miserable triad" of a proximal tibia fracture (OTA 41) with signs of threatened viability, and delay to revascularization ≥ 6 hours from injury or ≥ 2 hours from presentation was predictive of amputation (p = 0,036 and p = 0,018 respectively). Conclusions: We should aim to intervene within 6 hours following injury or 2 hours following presentation to reduce the risk of amputation. This provides a target for trauma teams even with uncertain time of injury. Level of Evidence: III. 2017-10-03T14:18:13Z 2017-10-03T14:18:13Z 2017 Master Thesis Masters MMed http://hdl.handle.net/11427/25507 eng application/pdf Department of Health and Rehabilitation Sciences Faculty of Health Sciences University of Cape Town |
| spellingShingle | Orthopaedic Surgery Roussot, Mark Amputation rate following tibia fractures with associated popliteal artery injuries |
| thesis_degree_str | Master's |
| title | Amputation rate following tibia fractures with associated popliteal artery injuries |
| title_full | Amputation rate following tibia fractures with associated popliteal artery injuries |
| title_fullStr | Amputation rate following tibia fractures with associated popliteal artery injuries |
| title_full_unstemmed | Amputation rate following tibia fractures with associated popliteal artery injuries |
| title_short | Amputation rate following tibia fractures with associated popliteal artery injuries |
| title_sort | amputation rate following tibia fractures with associated popliteal artery injuries |
| topic | Orthopaedic Surgery |
| url | http://hdl.handle.net/11427/25507 |
| work_keys_str_mv | AT roussotmark amputationratefollowingtibiafractureswithassociatedpoplitealarteryinjuries |