ArticleBMC surgery2026
Surgical revision for transtibial stump problems following war traumatic amputations: a 2016-2020 cohort from Aleppo, Syria.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundArmed conflicts often lead to a surge in traumatic amputations performed under emergency conditions with limited surgical standards. In Syria, over a decade of war has resulted in a high burden of residual limb complications among amputees, posing major barriers to prosthetic rehabilitation. Despite their clinical significance, long-term surgical outcomes of stump revision in such contexts remain scarcely documented.
methodsBetween 2016 and 2020, a total of 1,450 lower-limb amputees presented to the Syrian Arab Red Crescent Orthopedic clinic in Aleppo. Of these, 110 patients (120 transtibial stumps) who were unable to achieve prosthetic fitting due to residual limb complications underwent surgical revision. Complications included symptomatic neuromas, bony overgrowth, chronic ulcers, scar contractures, and redundant soft tissue. Residual limb length was objectively categorized into five groups (very short, short, optimal, long, Syme), and associations between stump characteristics, trauma mechanism, and complication type were analyzed. All patients were followed prospectively using a standardized multidisciplinary protocol to assess rehabilitation progress.
resultsBone spurs (45.8%) and symptomatic neuromas (22.5%) were the leading indications for revision surgery. Neuroma incidence was significantly higher in very short and short stumps (p < 0.01), while long and Syme-level stumps showed increased rates of bony overgrowth. Landmine and blast injuries were strongly associated with chronic ulcers (60%) and scar contractures (35%). Tailored surgical approaches, including nerve repositioning, bone contouring, and soft-tissue balancing, enabled successful prosthetic fitting in all cases. Functional reintegration was achieved within an average of 95–140 days post-revision.
conclusionThis prospective cohort highlights the predictable nature of stump complications based on residual limb length and injury mechanism in a war-injured population. Surgical revision, even with basic techniques, proved effective in restoring prosthetic use and function. These findings emphasize the critical importance of structured amputation protocols, optimal stump length preservation, and meticulous nerve handling to reduce long-term complications and achieve sustainable prosthetic rehabilitation in conflict zones and under-resourced surgical environments.
Indexed as
Identifiers
What OpenQuestion holds
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.