Gustilo type III B and III C high-energy tibial fractures

Summary

Patients treated with amputation had similar long-term functional and emotional outcomes as patients treated with reconstructive surgery. When considering reconstructive surgery over primary amputation, one must consider the risk of secondary amputation (range 5-14%), potential complications (generally higher among reconstructive surgery patients), and length of hospital stay. The literature is limited to a paucity of cohort studies that make this comparison, which may be confounded by severity of the fracture since patients with more severe tibial fractures (Gustilo type III C versus type III B) are more likely to be treated by amputation.