15,479 results match your criteria Amputations of the Lower Extremity


Clinically Important Reductions in Physical Function and Quality of Life in Adults with Tumor Prostheses in the Hip and Knee: A Cross-sectional Study.

Clin Orthop Relat Res 2021 May 10. Epub 2021 May 10.

L. Fernandes, M. K. Zebis, Department of Midwifery, Physiotherapy, Occupational Therapy, and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark.

Background: Patients with a bone sarcoma who undergo limb-sparing surgery and reconstruction with a tumor prosthesis in the lower extremity have been shown to have reduced self-reported physical function and quality of life (QoL). To provide patients facing these operations with better expectations of future physical function and to better evaluate and improve upon postoperative interventions, data from objectively measured physical function have been suggested.

Questions/purposes: We sought to explore different aspects of physical function, using the International Classification of Functioning, Disability, and Health (ICF) as a framework, by asking: (1) What are the differences between patients 2 to 12 years after a bone resection and reconstruction surgery of the hip and knee following resection of a bone sarcoma or giant cell tumor of bone and age-matched controls without walking limitations in ICF body functions (ROM, muscle strength, pain), ICF activity and participation (walking, getting up from a chair, daily tasks), and QoL? (2) Within the patient group, do ICF body functions and ICF activity and participation outcome scores correlate with QoL?

Methods: Between 2006 and 2016, we treated 72 patients for bone sarcoma or giant cell tumor of bone resulting in bone resection and reconstruction with a tumor prosthesis of the hip or knee. Read More

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Elabela as a novel marker: Well-correlated with WIfI amputation risk score in lower extremity arterial disease patients.

Anatol J Cardiol 2021 May;25(5):330-337

Department of Cardiology, Faculty of Medicine, Gaziantep University; Gaziantep-Turkey.

Objective: Worldwide, over 200 million people are diagnosed with lower extremity arterial disease (LEAD). LEAD significantly increases the risk of death and amputation of the lower limb. A new classification system (WIfI) has been proposed to initially assess all patients with ischemic rest pain or wounds and also predicts 1-year amputation risk. Read More

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Comparison of Pre-Amputation Evaluation in Patients with and without Chronic Kidney Disease.

Am J Nephrol 2021 May 6:1-8. Epub 2021 May 6.

Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.

Introduction: Patients with chronic kidney disease (CKD) and peripheral artery disease (PAD) are more likely to undergo lower extremity amputation than patients with preserved kidney function. We sought to determine whether patients with CKD were less likely to receive pre-amputation care in the 1-year prior to lower extremity amputation compared to patients without CKD.

Methods: We conducted a retrospective observational study of patients with PAD-related lower extremity amputation between January 2014 and December 2017 using a large commercial insurance database. Read More

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"When nothing happens, nobody is afraid!" beliefs and perceptions around self-care and health-seeking behaviours: Voices of patients living with diabetic lower extremity amputation in primary care.

Int Wound J 2021 May 6. Epub 2021 May 6.

Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Self-management and self-care are the cornerstone of diabetes care and an essential part of successfully preventing or delaying diabetes complications. Yet, despite being armed with the required information and guidance for self-management, self-care and adherence to foot self-care recommendations and compliance to medication among patients with diabetic foot ulcer and diabetic lower extremity amputations remain low and suboptimal. This study reveals in-depth account of nine such patients' beliefs and perceptions around their illness, their self-care, and their health-seeking behaviours. Read More

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Increased mortality with REBOA only mitigated by strong unmeasured confounding: an expanded analysis using the National Trauma Data Bank.

J Trauma Acute Care Surg 2021 May 5. Epub 2021 May 5.

Department of Surgery, Yale School of Medicine Applied Mathematics Program, Department of Mathematics, Yale University Department of Statistics and Data Science, Yale University.

REBOA is being increasingly adopted to manage non-compressible torso hemorrhage, but a recent analysis of the 2015-2016 Trauma Quality Improvement Project (TQIP) dataset showed that placement of REBOA was associated with higher rates of death, lower extremity amputation, and acute kidney injury (AKI). We expand this analysis by including the 2017 dataset, quantifying the potential role of residual confounding, and distinguishing between traumatic and ischemic lower extremity amputation.

Methods: This retrospective study used the 2015-2017 TQIP database and included patients older than 18 years old, with signs of life on arrival, no aortic injury, and were not transferred. Read More

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Incidence and demographic characteristics of Syrian Civil War-related amputations: A multi-center study.

Turk J Phys Med Rehabil 2021 Mar 4;67(1):48-55. Epub 2021 Mar 4.

Istanbul Leprosy, Skin and Venereal Diseases Hospital, Istanbul, Turkey.

Objectives: The aim of this study was to identify the causes, levels, and rates of amputations performed in civilians during the Syrian Civil War and to present epidemiological data of the amputees.

Patients And Methods: Between August 2017 and February 2019, a total of 363 amputations of 307 amputees (266 males, 41 females; mean age 29.9±13. Read More

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A comparison of revascularization methods for peripheral arterial disease in diabetics: Changing trends in lower extremity revascularization from 2008 to 2014.

Vascular 2021 May 4:17085381211012564. Epub 2021 May 4.

Department of Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, USA.

Objectives: This study examined the current demographic and outcome trends regarding endovascular and open revascularization for people with diabetes.

Methods: The National Inpatient Sample database was utilized to identify diabetic patients who underwent lower extremity revascularization and amputation procedures between 2008 and 2014. International Classification of Diseases 9th edition codes were used to identify the procedures, diagnoses, and comorbidities. Read More

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Traumatic Femoral Artery Injuries and Predictors of Compartment Syndrome: A Nationwide Analysis.

J Surg Res 2021 Apr 30;265:159-167. Epub 2021 Apr 30.

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona. Electronic address:

Background: The femoral artery is commonly injured following lower extremity trauma. If not identified early and addressed properly, it can lead to compartment syndrome (CS) and limb amputation. The aim of this study is to examine traumatic femoral artery injuries and identify risk factors for the development of lower extremity CS. Read More

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A Systematic Review and Meta-Analysis of Endovascular Angiosomal Revascularization in the Setting of Collateral Vessels.

J Vasc Surg 2021 Apr 30. Epub 2021 Apr 30.

Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital; Washington, District of Columbia. Electronic address:

Objectives: Endovascular procedures for targeted treatment of lower extremity wounds can be subdivided as direct (DR), indirect (IR), and indirect revascularization via collateral flow (IRc). While previous systematic reviews assert superiority of DR when compared to IR, the role of collateral vessels in clinical outcomes remains to be defined. This systematic review and meta-analysis aims to define the utility of DR, IR, and IRc in treatment of lower extremity wounds with respect to 1) wound healing, 2) major amputation 3) reintervention and 4) all-cause mortality. Read More

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Management Strategy for Lower Extremity Malperfusion Due to Acute Aortic Dissection.

J Vasc Surg 2021 Apr 30. Epub 2021 Apr 30.

Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of USC, Los Angeles, CA. Electronic address:

Objective: Aortic dissection can result in devastating cerebral, visceral, renal, spinal, and extremity ischemia. We describe the management and outcomes of patients presenting with aortic dissection and lower extremity malperfusion.

Methods: A single-center institutional aortic database was queried for patients with aortic dissection and lower extremity malperfusion (LEM) from 2011-2019. Read More

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A Focus on Non-Amputation Combat Extremity Injury: 2001-2018.

Mil Med 2021 May 3. Epub 2021 May 3.

Medical Modeling and Simulation, Naval Health Research Center, San Diego, CA 92106-3521, USA.

Introduction: Extremity injuries have comprised the majority of battlefield injuries in modern U.S. conflicts since World War II. Read More

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Postoperative healing in the diabetic foot is impacted by discharge destination.

Int Wound J 2021 May 2. Epub 2021 May 2.

Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan Medical School, Ann Arbor, Michigan, USA.

The aim of this study was to evaluate the impact of discharge destination on diabetes-related limb salvage surgery outcomes post-hospitalisation. This was a single-centre, observational, descriptive study of 175 subjects with diabetes who underwent limb salvage surgery of a minor foot amputation or wide incision and debridement for an acutely infected diabetic foot ulcer (DFU). Comparisons were made between subjects discharged home vs a skilled nursing facility (SNF) for 12 months postoperatively. Read More

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Effects of a Technology-Assisted Integrated Diabetes Care Program on Cardiometabolic Risk Factors Among Patients With Type 2 Diabetes in the Asia-Pacific Region: The JADE Program Randomized Clinical Trial.

JAMA Netw Open 2021 Apr 1;4(4):e217557. Epub 2021 Apr 1.

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.

Importance: Many health care systems lack the efficiency, preparedness, or resources needed to address the increasing number of patients with type 2 diabetes, especially in low- and middle-income countries.

Objective: To examine the effects of a quality improvement intervention comprising information and communications technology and contact with nonphysician personnel on the care and cardiometabolic risk factors of patients with type 2 diabetes in 8 Asia-Pacific countries.

Design, Setting, And Participants: This 12-month multinational open-label randomized clinical trial was conducted from June 28, 2012, to April 28, 2016, at 50 primary care or hospital-based diabetes centers in 8 Asia-Pacific countries (India, Indonesia, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam). Read More

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Pattern of upper limb amputation associated with lower limb amputation: the UK military experience from Iraq and Afghanistan.

BMJ Mil Health 2021 Apr 29. Epub 2021 Apr 29.

Academic Department for Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.

Introduction: The conflicts in Iraq and Afghanistan resulted in large numbers of personnel sustaining extremity injuries. In the context of polytrauma, partial hand amputation is often unrecorded. The aim of this work was to quantify the burden of upper limb (UL) amputation at any level occurring concurrently with a major (ankle and proximal) lower limb (LL) amputation. Read More

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What Is Currently the Role of TcPO2 in the Choice of the Amputation Level of Lower Limbs? A Comprehensive Review.

J Clin Med 2021 Apr 1;10(7). Epub 2021 Apr 1.

Service d'Angiologie, Département Coeur et Vaisseaux, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.

Some patients still require major amputation for lower extremity peripheral arterial disease treatment. The purpose of pre-operative amputation level selection is to determine the most distal amputation site with the highest healing probability without re-amputation. Transcutaneous oximetry (TcPO2) can detect viable tissue with the highest probability of healing. Read More

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Selective screening imaging of the aortoiliac arterial system in kidney transplant candidates with non-contrast pelvic computed tomography.

Clin Transplant 2021 Apr 29:e14331. Epub 2021 Apr 29.

Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX, USA.

Non-contrast pelvic computed tomography (CT) can detect severe iliac artery calcifications that present technical contraindications to kidney transplantation (TCT). We screened 454 asymptomatic patients with a history of any of the following: hemodialysis >10 years, diabetes mellitus >20 years, coronary artery disease (CAD) with percutaneous or surgical interventions, carotid disease, diabetes with below-/above-knee amputations, heart-kidney transplantation candidacy. Patients with normal dorsalis pedis and/or tibialis posterior pulses were not screened. Read More

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Area Deprivation Index Score Is Associated with Lower Rates of Long Term Follow-up after Upper Extremity Vascular Injuries.

Ann Vasc Surg 2021 Apr 25. Epub 2021 Apr 25.

Division of Vascular and Endovascular Surgery, St. Louis University, St. Louis, MO, USA.

Objective: The Area Deprivation Index (ADI) has been shown to be a determinant of healthcare outcomes in both medical and surgical fields, and is a measure of the socioeconomic status of patients. We sought to analyze outcomes in patients with upper extremity vascular injuries that were admitted over a five-year period to a Level I trauma center sorted by ADI.

Methods: All patients with upper extremity vascular injury presenting to a level one trauma center between January 2013 and January 2017 were retrospectively collected. Read More

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A Scoping Review of Physical Activity in People With Lower-Limb Loss: 10,000 Steps Per Day?

Phys Ther 2021 Apr 28. Epub 2021 Apr 28.

Program in Physical Therapy, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032.

Objective: After amputation, people with lower-limb loss (PLL) face challenges to regain their previous physical activity level. Assessing the scope of evidence regarding physical activity in PLL can identify sources of evidence and gaps within the literature that can influence amputation-related research, outcome assessment choices, and wellness activities. The purpose of this scoping review was to map the evidence regarding steps per day as a physical activity measure for PLL. Read More

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Long-term Mortality of a Cohort of Patients Undergoing Surgical Treatment for Diabetic Foot Infections. An 8-year Follow-up Study.

Int J Low Extrem Wounds 2021 Apr 28:15347346211009425. Epub 2021 Apr 28.

118003San Juan de Dios Hospital, San José, Costa Rica.

We analyzed a retrospective cohort of 150 patients with diabetic foot infections (DFIs) who underwent surgical treatment to determine long-term outcomes. The median follow-up of the series was 7.6 years. Read More

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Sex related differences in therapy and outcome of patients with intermittent claudication in a real-world cohort.

Atherosclerosis 2021 Mar 25;325:75-82. Epub 2021 Mar 25.

Dept. of Cardiology I - Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol., Muenster, Germany.

Background And Aims: The prevalence of lower extremity artery disease (LEAD) is increasing worldwide and sex-related differences are a current matter of debate.

Methods: We analysed claims data on unselected patients with in-patient treatment for LEAD with intermittent claudication (IC; Rutherford grade 1-3) from 01.01. Read More

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Fall risk classification for people with lower extremity amputations using random forests and smartphone sensor features from a 6-minute walk test.

PLoS One 2021 26;16(4):e0247574. Epub 2021 Apr 26.

Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Fall-risk classification is a challenging but necessary task to enable the recommendation of preventative programs for individuals identified at risk for falling. Existing research has primarily focused on older adults, with no predictive fall-risk models for lower limb amputees, despite their greater likelihood of fall-risk than older adults. In this study, 89 amputees with varying degrees of lower limb amputation were asked if they had fallen in the past 6 months. Read More

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Increased Use of Prehospital Tourniquet and Patient Survival: Los Angeles Countywide Study.

J Am Coll Surg 2021 Apr 3. Epub 2021 Apr 3.

Department of Surgery, University of Southern California, Los Angeles, CA.

Background: The recent trends in prehospital tourniquet use remain underreported. In addition, the impact of prehospital tourniquet use on patient survival has not been evaluated in a population-level study. We hypothesized that prehospital tourniquets were more frequently used in Los Angeles County and their use was associated with improved patient survival. Read More

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Enhanced Post-Operative Recovery With Continuous Peripheral Nerve Block After Lower Extremity Amputation.

Ann Vasc Surg 2021 Apr 22. Epub 2021 Apr 22.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA. Electronic address:

Objective: Despite progress in perioperative care standards, there has not been a significant risk reduction in morbidity and mortality rates of lower extremity amputations, an intermediate risk surgery performed on high risk patients. The single-shot peripheral nerve block has shown equivocal impact on postoperative course following lower extremity amputation. Hence, we assessed the potential of preemptive use of continuous catheter-based peripheral nerve block in lower extremity amputations for reduction in pulmonary complications, acute post-operative pain scores, and opioid use in post-operative period. Read More

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A Leg to Stand On: Trauma Center Designation and Association with Rate of Limb Salvage in Patients Suffering Severe Lower Extremity Injury.

J Am Coll Surg 2021 Apr 19. Epub 2021 Apr 19.

Department of Plastic and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL USA; Department of Surgery, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.

Background: Mangled extremities are one of the most difficult injuries for trauma surgeons to manage. We compare limb salvage rates for a limb-threatening lower extremity injury managed at Level I versus Level II trauma centers (TCs).

Study Design: We identified all adult patients with a limb-threatening injury who underwent primary amputation or limb salvage (LS) using the American College of Surgeons (ACS) Trauma Quality Improvement Program database at ACS Level I vs. Read More

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Diabetes-related lower extremity complications in a multi-ethnic Asian population: a 10 year observational study in Singapore.

Diabetologia 2021 Apr 22. Epub 2021 Apr 22.

Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore.

Aims/hypothesis: Diabetes progression and complication risk are different in Asian people compared with those of European ancestry. In this study, we sought to understand the epidemiology of diabetes-related lower extremity complications (DRLECs: symptomatic peripheral arterial disease, ulceration, infection, gangrene) and amputations in a multi-ethnic Asian population.

Methods: This was a retrospective observational study using data obtained from one of three integrated public healthcare clusters in Singapore. Read More

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American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary for Limb Salvage or Early Amputation.

J Am Acad Orthop Surg 2021 Apr 16. Epub 2021 Apr 16.

From the Walter Reed National Military Medical Center-Uniformed Services University of Health Sciences, Bethesda, MD (Potter), and Department of Orthopaedics, Atrium Health, Carolinas Medical Center, Charlotte, NC (Bosse).

Clinical Practice Guideline for Limb Salvage or Early Amputation is based on a systematic review of current scientific and clinical research. The purpose of this clinical practice guideline is to address treatment for severe lower limb trauma below the distal femur by either amputation or limb salvage by providing evidence-based recommendations for key decisions that affect the management of patients with lower extremity trauma. This guideline contains 11 recommendations to evaluate the decision factors important for limb salvage versus early amputation. Read More

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Injuries after Forklift Trucks Accidents - Injury Patterns, Therapy and Outcome in the Context of the Statutory Accident Insurance.

Z Orthop Unfall 2021 Apr 19. Epub 2021 Apr 19.

Department of General and Trauma Surgery, BG University Hospital, Bochum, Germany.

Introduction: The use of forklift trucks during work has a high accident potential. The aim of this study is to describe injury patterns, treatment and outcome after forklift truck accidents in the context of the employers' liability insurance association.

Methods: Retrospective data collection of all cases between 2004 and 2019. Read More

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The Biomechanics of Diabetic Foot Amputation.

Wounds 2021 04 14. Epub 2021 Apr 14.

Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania.

According to the International Diabetes Federation, approximately 463 million adults live with diabetes mellitus (DM), a number projected to increase to 700 million by 2045; a diabetic foot ulcer (DFU) will occur in about 15% of that population. Multiple factors contribute to the development of those wounds including diabetic peripheral neuropathy, biomechanical imbalances, trauma, and peripheral vascular disease. In addition, 85% of all lower limb amputations in patients with diabetes are preceded by a DFU resulting in significant biomechanical challenges for these patients, many of who never become ambulatory again. Read More

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Could prior endovascular interventions affect the results of lower extremity below the knee autologous vein bypasses?

Int Angiol 2021 Apr 19. Epub 2021 Apr 19.

Vascular and Endovascular Surgery Department, Hospital Universitario Dr.Peset, Valencia, Spain.

Background: Performing a non-selective primary endovascular approach involves risk of performing ineffective procedures and could compromise future treatments. The objective of this research is to determine if previous failed endovascular intervention could affect bypass results.

Methods: Retrospective cohort study including 77 below the knee (BTK) bypasses with great saphenous vein (GSV) in patients with critical limb ischemia, carried out between 2008-2018. Read More

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Two-year PAD-related health care costs in patients undergoing lower extremity endovascular revascularization: results from the LIBERTY 360° trial.

J Med Econ 2021 Jan-Dec;24(1):570-580

University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA.

Background: Multiple studies have demonstrated the high economic burden related to the management of lower extremity peripheral artery disease (PAD). This is the first study to examine long-term PAD-related costs among unselected patients undergoing endovascular intervention, and to investigate how clinical and anatomic factors impact cost outcomes over time.

Methods And Results: We performed a prospective health economic study alongside the LIBERTY 360° trial (ClinicalTrials. Read More

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