What is Lower Extremity Limb Salvage?
Limb salvage refers to procedures that can help individuals affected by a number of disorders from the pelvis to the foot. Conditions that may benefit from limb salvage include issues with blood supply, diabetic conditions of the foot, infections, tumors, and other conditions affecting the bones of the lower extremity.
In the past, many of these conditions were treated with amputation. Individuals who have been treated with an amputation have significant disability related to their amputation. Thankfully, advances in technology have made it possible to safely treat many of these conditions without the need for amputation.
Who should I see for Lower Extremity Limb Salvage?
Over the last twenty years, it has been shown that individuals who are at risk for amputation have better outcomes when treated by a team of doctors and healthcare providers experienced in saving limbs.
A limb salvage team should consist of a wound care doctor, wound care nurses, vascular surgeons, orthopedic surgeons, infectious disease doctors, specialists in orthotics and prosthetics, as well as specialists who can offer hyperbaric oxygen therapy.
What is the role of an orthopedic surgeon in Lower Extremity Limb Salvage?
When an individual has an infection that does not heal with medical treatments, an orthopedic surgeon may be able to clean out the infection in the operating room. This allows for more extensive cleaning (debridement) of the infected area helping the individual to fight the infection.
When an individual has changes in their bones that create abnormal pressure on the skin, this could lead to ulcers which could cause complications leading to amputation. An orthopedic surgeon can realign the bones allowing the individual to walk better without putting abnormal pressure on the leg.
Lower Extremity Limb salvage requires an orthopedic surgeon that is confident that they can treat the problem and allow healing to occur after the surgery so the individual can use the leg for walking. The orthopedic surgeon must have a plan for reconstruction of the limb. MRI or CT may be necessary to make a detailed surgical plan. The orthopedic surgeon may refer an individual to a vascular surgeon to make sure there is blood flowing to the leg which helps in the healing process after surgery.
Once the surgery has been complete, the individual will need to be closely monitored by the team as the healing process begins. This requires office visits with the orthopedic surgeon, the vascular surgeon, the wound care team, and the infectious disease doctor. An individual may also be evaluated for hyperbaric oxygen treatment.
– Written by Dr. Justin Kane, Orthopedic Institute of North Texas (OINT)