Limb salvage results of Gustilo IIIC fractures of the lower extremity


limb salvage; gustilo-anderson; grade IIIC; lower extremity; amputation

Published online: Jan 22 2023

Emre Ozmen, Halil İbrahim Balci, Ahmet Salduz, İbrahim Levent Eralp

From the Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey


This study aims to present our results for limb sal- vage in Gustilo IIIC open fractures of the femur and tibia. 92 patients with Gustilo IIIC fractures operated in our clinic between January 2000 and March 2016 were retrospectively evaluated. Demographic data, ischemia time, method of arterial repair, means of primary and secondary fixation, time to amputation, complications, and final VAS scores were recorded. The difference between the primary amputation rates of tibia and femur fractures was not statisti- cally significant (18% vs 21%, p>0.05). The difference between the secondary amputation rates of tibia and femur fractures was not significant (16% vs 27%, p>0.05). All secondary amputations were done within the first month during the initial hospital stay. Overall limb salvage rate was 69% for Gustilo IIIC fractures of the femur and 58% for Gustilo IIIC fractures of the tibia. The overall limb salvage rate was not signifi- cantly different between the two groups (p>0.05). At the final follow-up, patients in the limb salvage group had average VAS scores of 4.3 (femur) and 4.7 (tibia). The decision between amputation versus limb salvage remains a difficult decision that should be jointly made by the treating physicians and the patient.