Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Systemic
Abstract number: 26387
BILATERAL TRAUMATIC MAJOR AMPUTATION OF THE LOWER EXTREMITIES
-GENESIS AND OUTCOME
Wolfgang ARMBRUSTER, Bahram BIGLARI, Dietrich SCHULTE-BOCKHOLDT, Paul
Alfred GRÜTZNER, Christian FRANK
BG Unfallklinik Ludwigshafen, Ludwigshafen (GERMANY)
Aim:Injury patterns resulting in bilateral traumatic major amputation of the lower
extremities are examined in respect to cause, rehabilitation capabilities,
reestablishment of mobility and return to workplace.Methods:Injuries resulting in
bilateral lower extremity amputation during the past 5 years were identified. Cases
were examined according to mechanism, severity of additional injuries, fatalities,
extent of mobility, number and type of prosthetic implants, and ability to return to
work.Results :12 patients between 9 and 77 years of age were treated; seven of
which were transferred from another hospital. Mechanism of injury was always high
impact trauma; 8 of those had multiple severe injuries.Apart from the 6 patients who
were run over, there were 4 work related injuries from high pressure machines, one
explosive injury, and one patient in whom the lower extremities were left as stumps
after a burn injury.There was one fatality was due to hemorrhagic shock. After
careful stump conditioning, bipedal ambulation was reestablished in a total of 9
patients with bilateral leg prosthetics. 7 patients were able to return to work.One
patient received bilateral Endo-Exoprostheses, and one patient received a bilateral
C-Leg prosthesis.Negative predictors of walking ability with prostheses include
advanced age and soft tissue problems. Conclusion:Even after mutilating injuries
resulting in bilateral major amputation of the lower extremities ambulation remains
possible.After life saving therapies are carried out, therapy should be begun in a
center capable of prosthesis fitting and specialized rehabilitation and prosthetic
ambulation therapy.
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