OBJECTIVES: To assess the incidence of fluid collections in postoperative amputee stumps and the impact on limb-fitting outcomes in patients with such collections. DESIGN: Cohort study. SETTING: Inpatient rehabilitation ward. PARTICIPANTS: Successive patients with amputation examined with ultrasound over 1 year. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The presence of discrete fluid collections on admission and outcomes of successful limb fitting, length of inpatient stay, and presence of psychologic symptoms. RESULTS: In 105 consecutive admissions, we detected discrete fluid collections in 28 (27%) of stumps with a median volume of 38.5 mL (range, 16-216 mL). All collections diminished and disappeared by discharge with 81% undetectable within 30 days since surgery. A transfemoral amputee was more likely to develop a collection than a transtibial amputee (P<.01). Patients with collections took 9.5 days longer to achieve limb fitting (P=.04) and had a 10-day longer inpatient stay (P=.02). However, the overall success of limb fitting was similar as was the incidence of psychologic distress. CONCLUSIONS: Discrete fluid collections are common in postoperative amputation stumps but regress by discharge. Although limb fitting may be delayed, the ultimate success of limb fitting is not reduced and patients can be reassured.
OBJECTIVES: To assess the incidence of fluid collections in postoperative amputee stumps and the impact on limb-fitting outcomes in patients with such collections. DESIGN: Cohort study. SETTING: Inpatient rehabilitation ward. PARTICIPANTS: Successive patients with amputation examined with ultrasound over 1 year. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The presence of discrete fluid collections on admission and outcomes of successful limb fitting, length of inpatient stay, and presence of psychologic symptoms. RESULTS: In 105 consecutive admissions, we detected discrete fluid collections in 28 (27%) of stumps with a median volume of 38.5 mL (range, 16-216 mL). All collections diminished and disappeared by discharge with 81% undetectable within 30 days since surgery. A transfemoral amputee was more likely to develop a collection than a transtibial amputee (P<.01). Patients with collections took 9.5 days longer to achieve limb fitting (P=.04) and had a 10-day longer inpatient stay (P=.02). However, the overall success of limb fitting was similar as was the incidence of psychologic distress. CONCLUSIONS: Discrete fluid collections are common in postoperative amputation stumps but regress by discharge. Although limb fitting may be delayed, the ultimate success of limb fitting is not reduced and patients can be reassured.
Authors: Elizabeth M Polfer; Benjamin W Hoyt; Lien T Senchak; Mark D Murphey; Jonathan A Forsberg; Benjamin K Potter Journal: Clin Orthop Relat Res Date: 2014-10 Impact factor: 4.176