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<p>Amputation is often an unavoidable surgical procedure, especially in cases of severe limb damage. It is indicated when reconstructive or vascular surgical procedures fail to restore sufficient function to the affected limb. Criteria include progressive infection, critical ischemia, and irreversible tissue loss. In rare cases, tumors can also be the cause, but these are not the subject of this paper. Nonfunctional limbs that do not provide mobility or strength are also important indications. In these cases, amputation serves not only to prevent secondary complications, but also to restore pain-free mobility through targeted prosthetic treatment. Innovative developments such as osseointegrated prosthesis systems offer a&#xa0;promising alternative to conventional socket prostheses. These approaches have been shown to improve mobility and quality of life. Various scoring systems, such as the Mangled Extremity Severity Score (MESS) or the Predictive Salvage Index (PSI), assist in decision-making between amputation and limb preservation. While these systems provide objective decision support, they are limited in their predictive value. Therefore, the decision is always individual and requires a&#xa0;multidisciplinary approach that takes into account the clinical context and patient-specific factors.</p>

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Kniegelenksnahe Amputationen nach schweren Verletzungen – Entscheidungsfindung und Therapieoptionen

  • 期刊论文

  • 发表日期：

    2025年2月24日

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  • Alonja Reiter,
  • Karl-Heinz Frosch,
  • Matthias Priemel

摘要

Amputation is often an unavoidable surgical procedure, especially in cases of severe limb damage. It is indicated when reconstructive or vascular surgical procedures fail to restore sufficient function to the affected limb. Criteria include progressive infection, critical ischemia, and irreversible tissue loss. In rare cases, tumors can also be the cause, but these are not the subject of this paper. Nonfunctional limbs that do not provide mobility or strength are also important indications. In these cases, amputation serves not only to prevent secondary complications, but also to restore pain-free mobility through targeted prosthetic treatment. Innovative developments such as osseointegrated prosthesis systems offer a promising alternative to conventional socket prostheses. These approaches have been shown to improve mobility and quality of life. Various scoring systems, such as the Mangled Extremity Severity Score (MESS) or the Predictive Salvage Index (PSI), assist in decision-making between amputation and limb preservation. While these systems provide objective decision support, they are limited in their predictive value. Therefore, the decision is always individual and requires a multidisciplinary approach that takes into account the clinical context and patient-specific factors.