Ann Plast Reconstr Surg | Volume 6, Issue 3 | Research Article | Open Access

Complex Foot Trauma: Amputation vs. Reconstruction - Clinical Evaluation and Long-Term Quality of Life

Al khaled N1, Manegold S2, Tsitsilonis S1 and Krapohl BD3*

1Center for Musculoskeletal Surgery, Charité - Medical University of Berlin, Germany
2Department of Orthopedic and Trauma Foot Surgery, BG Unfallklinik Frankfurt am Main, Germany
3Department of Maxillary, Craniofacial, Plastic and Reconstructive Surgery, Hospital Carl Thiem Clinic Cottbus, Germany

*Correspondance to: Bj√∂rn Dirk Krapohl 

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Background: Complex foot injuries are debilitating injuries that can negatively affect patients’ quality of life. Traditionally, amputation was a typical treatment for these injuries. With the development of new surgical techniques, foot salvage has since found its place as a treatment modality of complex foot trauma. With this change arouse the question: Which treatment of the two is the best option for patients? In this retrospective cross sectional cohort study, the two treatment outcomes are compared. This study also evaluates the patients’ quality of life, and the bacterial contamination levels of open wounds resulting from complex foot trauma.
Patients and Methods: 26 patients with complex foot trauma were recruited retroactively from 2002 through 2014. Their quality of life was evaluated using five self-report questionnaires. The results of bacterial cultures taken from open wounds of complex foot trauma were collected. The patients were categorized in two groups: Amputation vs. reconstruction. They were compared in
terms of features of foot injury, the number of surgical interventions, complications, the length of hospital stay, and accompanying multiple traumas. Zwipp score correlation with mentioned variables was calculated.
Results: 22 patients (76.9%) were in the foot reconstruction group, and four patients (15.3%) in the foot amputation group. No significant difference was found between the two groups within the parameters studied. The only exception was the Zwipp score: Here the amputations group had a significant worse score, p=0.009. Function scores were worse than pain scores. No significant
difference was found in scores of quality of life between amputation and reconstruction groups. More than half of the open wound microbiological cultures were negative for bacterial growth.
Conclusion: Complex foot trauma remains an incapacitating injury with either treatment. Neither of the two treatments (salvage and amputation) proved to be a superior option for the patients. Functional restrictions were the main causes of low quality of life. The improvement of functional rehabilitation programs should be focused on to achieve better outcomes.


Complex foot trauma; Reconstruction; Amputation; Bacterial burden of open wounds; Quality of life


Al khaled N, Manegold S, Tsitsilonis S, Krapohl BD. Complex Foot Trauma: Amputation vs. Reconstruction - Clinical
Evaluation and Long-Term Quality of Life. Ann Plast Reconstr Surg. 2022;6(3):1094..

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