Rescue and treatment of severely injured lower extremities.

OBJECTIVE

To explore a treatment approach for severely injured lower extremities.

METHODS

The data of 42 patients with severely traumatic lower extremities from 1989 to 1999 were retrospectively reviewed. According to MESS (mangled extremity severity score) the mean score of all the limbs was 6.24+/-1.45, 34 cases had MESS score < 7 and 8 cases had MESS score > or = 7. Treatment approaches included microvascular anastomosis technique, compound tissue flap transplantation technique and compound bone tissue flap transplantation.

RESULTS

Two patients died after operation and one patient had delayed amputation of a lower limb. The rest 39 patients were followed up for 4-13 years. All the lower extremities of the 39 patients survived and had equal length. The 39 cases were evaluated by Chen's criterion, showing that 37 had good result (29, Chen I and 8, Chen II), 1 sufficient (Chen III) and 1 poor (Chen IV).

CONCLUSIONS

Successful emergency treatment of severely injured lower extremities could be achieved by using microsurgery techniques and strict controlling of lower extremity salvagel indications.