The function of below-knee amputee versus the patient with salvaged grade III tibial fracture.

This retrospective study compares the end-stage function of the traumatic below-knee amputee with that of the patient with salvaged Grade III tibial fracture. Twenty-four patients, 12 below-knee amputees and 12 with salvaged tibiae, were interviewed and examined one year or more after the completion of treatment. Emphasis was on function of the limb, the patient, and the quality of life. The early amputees had higher scores, fewer operations, and six-week hospitalization on average, and returned to work and sport within six months. Neither the amputees, nor the salvaged group, functioned entirely normally. Most patients made significant alterations to work and sporting activities, and approximately one third believed there was deterioration in the quality of life. These results suggest that amputation should be strongly considered when confronted with a borderline salvageable tibial injury or prolonged salvage attempts.