Amputation versus functional reconstruction in the management of complex hind foot injuries caused by land-mine explosions: A long-term retrospective comparison

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dc.contributor.authorDemiralp, Bahtiyar
dc.contributor.authorEge, Tolga
dc.contributor.authorKöse, Özkan
dc.contributor.authorYurttaş, Yüksel
dc.contributor.authorBaşbozkurt, Mustafa
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:36:31Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:36:31Z
dc.date.issued2014
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı
dc.description.abstractThe purpose of this study is to compare the long-term clinical outcomes of patients who were treated with either hind foot reconstruction or amputation in complex hind foot injuries accompanied with bone and soft tissue loss due to land-mine explosions. Between 1994 and 2004, all patients with hind foot complex injuries due to land-mine explosion, who were operated in our clinic, were enrolled to the study. All patients were evaluated with Short-Form 36 (SF-36), Foot and Ankle Disability Index (FADI) and Body Image Quality of Life Inventory (BIQLI) after a mean of 15.1 ± 2.2 (range 9-19) years of follow-up. Demographic characteristics, number of operations, necessity of psychiatric treatment and all complications were compared between groups. There were a total of 42 patients [21 in reconstruction group (Gr I) and 21 in amputation group (Gr II)]. The mean age at the time of final follow-up was 38.4 ± 3.04 years in Gr I and 38.2 ± 4.24 years in Gr II (p = 0.732). The mean follow-up duration was 15.7 ± 2.07 years in Gr I and 14.57 ± 2.29 years in Gr II (p = 0.081). The number of operations was significantly higher in Gr I (8.66 ± 10.2 times vs. 4.42 ± 7.7 times, respectively, p = 0.001). The mean FADI score at the final follow-up was 64.3 ± 18.1 in Gr I. In amputation group, more patients needed psychotherapy due to major depression (12 patients vs. 4 patients, p = 0.012). Major complications in Gr I were musculocutaneous flap atrophy in calcaneal region (n = 8 patients), limited ankle motion (n = 11) and painful osteophytes on plantar region (n = 6). In Gr II, stump problems were dominating (pain and tenderness n = 10, ulcer n = 2, allergic skin lesions n = 7, painful neuroma n = 10, bony spur n = 5, paresthesia n = 1, excessive sweating n = 12). At the final visit, although SF-36 scores were similar between groups (p = 0.182), extremity reconstruction group had significantly higher BIQLI scores than the amputation group (p = 0.016). If the dorsalis pedis is intact and midfoot and forefoot is relatively protected, hind foot reconstruction should be attempted. Long-term outcomes of hind foot reconstruction are satisfactory with minor complications and better BIQLI.
dc.identifier.citationDemiralp, B., Ege, T., Köse, Ö., Yurttaş, Y. ve Başbozkurt, M. (2014). Amputation versus functional reconstruction in the management of complex hind foot injuries caused by land-mine explosions: A long-term retrospective comparison. European Journal of Orthopaedic Surgery and Traumatology, 24(4), 621-626. https://dx.doi.org/10.1007/s00590-013-1345-4
dc.identifier.doi10.1007/s00590-013-1345-4
dc.identifier.endpage626
dc.identifier.issn1633-8065
dc.identifier.issue4
dc.identifier.scopusqualityQ3
dc.identifier.startpage621
dc.identifier.urihttps://hdl.handle.net/20.500.12511/1188
dc.identifier.urihttps://dx.doi.org/10.1007/s00590-013-1345-4
dc.identifier.volume24
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer-Verlag France
dc.relation.ispartofEuropean Journal of Orthopaedic Surgery and Traumatologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectHind Foot
dc.subjectIlizarov Method
dc.subjectLand-Mine Injuries
dc.subjectOpen Calcaneal Fractures
dc.subjectReconstruction
dc.titleAmputation versus functional reconstruction in the management of complex hind foot injuries caused by land-mine explosions: A long-term retrospective comparison
dc.typeArticle

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