The Severely Traumatized Lower Limb: Reconstruction versus Amputation--

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Symposium: Limb Reconstruction versus Amputation Decision Making in Massive Lower Extremity *Trauma.* Lange-Richard-H. Clinical Orthopaedics and Related Research. 1989 Jun. 243. pp 92-99. AB Massive lower extremity *trauma,* in particular open tibial fractures with associated vascular injuries, presents an immediate and complex decision-making challenge between a limb salvage attempt and primary amputation. Unfortunately, the literature to date is deficient in providing sound and defensible guidelines for primary amputation. Individual patient variables, specific extremity injury characteristics, and associated injuries must all be weighed before a decision can be reached. Further prospective studies are necessary before a well-defined protocol for primary amputation can be properly developed.