SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2022
Primary amputation versus limb salvage in upper limb major trauma: a systematic review.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 28 citations in OpenAlex.
- Major hand replantation at the carpometacarpal level: A case report.Radiology case reports · 2026Article
- Overview of the limb injury measurement battery for quality of life (LIMB-QOL).Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Review
- Clinical outcome of extremity arterial injuries in the modern era.Turkish journal of medical sciences · 2026Article
- Demographic and clinical features of extremity crush injuries resulting from entrapment under the rubble: an orthopedic perspective.Archives of orthopaedic and trauma surgery · 2025Article
- Functional outcomes and mortality after multi-limb amputations following the 2023 Türkiye earthquake: a two-year follow-up study from a level I trauma center.Journal of orthopaedic surgery and research · 2025Article
- Review
- Successful salvage of a crushed upper limb and reconstruction of brachial artery injury using a saphenous venous graft.Journal of vascular surgery cases and innovative techniques · 2025Article
- Induced Membrane Wrist Fusion with Ring External Fixator Assistance in a Mangled Upper Extremity: A Case Report.Journal of orthopaedic case reports · 2025Article
- Viability and Functional Prognosis in Mangled Hand Casualties Depending on Their Etiological Factors. A Study of 31 Cases.Journal of hand surgery global online · 2025Article
- Free-Functioning Muscle Transfers After Major Upper Limb Replantation.Journal of hand surgery global online · 2025Article
- Limb Salvage and Reconstruction of a Complex Upper Extremity Injury: A Case Report.Journal of orthopaedic case reports · 2025Article
- The long-term functional outcome of the mangled upper extremity intricate management. A single center experience.Journal of hand and microsurgery · 2025Article
- Upper extremity vascular injuries: Etiology, management and outcome.World journal of critical care medicine · 2024Article
- Reliability of Long Vein Grafts for Reconstruction of Massive Wounds.Journal of clinical medicine · 2023Article
- Crush syndrome: a review for prehospital providers and emergency clinicians.Journal of translational medicine · 2023Review
- Application of Emergency Specialist Nursing Combined with Green Channel Mode in Patients with Limb Amputation.Applied bionics and biomechanics · 2022Article
- Damage control strategy in peripheral vascular injury caused by firearm: A case report.Medicine internationalArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSevere upper limb injuries can result in devastating consequences to functional and psychological well-being. Primary objectives of this review were to evaluate indications for amputation versus limb salvage in upper limb major trauma and whether any existing scoring systems can aid in decision-making. Secondary objectives were to assess the functional and psychological outcomes from amputation versus limb salvage.
methodsA systematic review was carried out in accordance with PRISMA guidelines. A search strategy was conducted on the MEDLINE, EMBASE, and Cochrane databases. Quality was assessed using the ROBINS-I tool. The review protocol was registered in PROSPERO.
resultsA total of 15 studies met inclusion criteria, encompassing 6113 patients. 141 underwent primary amputation and 5972 limb salvage. General indications for amputation included at least two of the following: uncontrollable haemodynamic instability; extensive and concurrent soft tissue, bone, vascular and/or nerve injuries; prolonged limb ischaemia; and blunt arterial trauma or crush injury. The Mangled Extremity Severity Score alone does not accurately predict need for amputation, however, the Mangled Extremity Syndrome Index may be a more precise tool. Comparable patient-reported functional and psychological outcomes are seen between the two treatment modalities.
conclusionsDecision regarding amputation versus limb salvage of the upper limb is multifactorial. Current scoring systems are predominantly based on lower limb trauma, with lack of robust evidence to guide management of the upper extremity. Further high-quality studies are required to validate scoring systems which may aid in decision-making and provide further information on the outcomes from the two treatment options.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.