Short summary

This study aims to identify indications for major lower extremity amputation. Secondary, the study examines the preoperative-assessment including imaging and revascularization procedures. Through patient records, this study will compare the indications and preoperative assessment for all first time major lower extremity amputations carried out in a two-year period at the Department of Orthopedic Surgery and Traumatology at Odense University Hospital

Rationale

Major lower extremity amputations (MLEA) is a drastic experience that is associated with high morbidity and mortality. Up to 90% of MLEAs are estimated to be attributed to underlying vascular disease. However, Indications for MLEAs include chronic limb ischemia (CLI), acute limb ischemia (ALI), infection, oncologic condition, trauma, implant failure or congenital disorder. A change in the prevalence of indications was seen in the US from 2000-2016, with CLI either alone, or paired with infection was the most frequent.

How to determine the best initial amputation level, with the longest possible stump and the lowest risk of re-amputation is an ongoing discussion (3). The use of computer tomography angiography (CTA) for pre-operative assessment of vascular MLEAs is previously described (4, 5).

In Denmark approximately 1000 individuals experience a first-time MLEA (6). The index level of amputation is trending more proximally, with a significant increase in transfemoral amputations (TFA), while knee disarticulations (KD) and transtibial amputations (TTA) are declining.

Examining the reasons behind this difference in amputation level from patient registers is complex and thus, this study explore the indications for MLEAs through data extracted from patient records at Odense University Hospital. Hence, this study primary aim to identify indications of major lower extremity amputation. Secondary to examine the pre-assessment including imaging and revascularization procedures.

Description of the cohort

All first time major lower extremity amputations carried out in a two-year period at the Department of Orthopedic Surgery and Traumatology at Odense University Hospital

Data and biological material

This study will rely solely on retrospective data collected from patient records.