Orthopaedic trauma mythbusters: is limb salvage the preferred method of treatment for the mangled lower extremity?

Orthopaedic education is replete with unsubstantiated recommendations (myths) from predecessors in the field of orthopaedics. Even in the presence of sound evidence, some of these myths can be perpetuated through generations. One such recommendation is that if a mangled lower extremity can be saved, it should be saved. Recent technical and biologic advances allow the salvage of limbs that often required amputation in the past. Today's physicians must decide whether the physical, emotional, and financial costs of limb salvage can be justified by the expected functional outcome. Accumulated evidence suggests that functional outcomes are similar for amputation and limb salvage, whereas those treated with limb salvage have more hospitalizations and longer treatment times.