Multidisciplinary Approaches to Limb Salvage in Traumatic Extremity Injuries From Emergency Triage to Definitive Vascular, Orthopedic, and Reconstructive Surgery: A Systematic Review.

This systematic review explores the impact of multidisciplinary team (MDT) approaches in the management of complex limb injuries, comparing limb salvage and amputation outcomes across diverse trauma settings. Drawing from six recent studies involving both acute and chronic extremity trauma, the findings highlight consistent benefits of coordinated care involving orthopedic, vascular, and plastic surgery specialties. These include reduced flap loss, faster time to definitive fixation, improved functional recovery, and enhanced decision-making regarding salvage versus amputation. While functional and psychological outcomes following salvage and amputation were often comparable, early MDT involvement improved wound healing and lowered short-term mortality rates in select patient groups. Variability in outcomes was influenced by institutional resources, timing of intervention, and patient comorbidities. Scoring systems such as the Mangled Extremity Severity Score (MESS) and the Mangled Extremity Syndrome Index (MESI) aided but did not replace clinical judgment. Overall, the integration of multidisciplinary pathways into trauma care enhances outcome quality and supports patient-centered decision-making in complex limb trauma cases.