Rates of Complications Following Lower Extremity Amputations: A Retrospective Chart Review

Abstract

Category: Ankle; Diabetes; Hindfoot; Lesser Toes; Midfoot/Forefoot; Trauma; Other Introduction/Purpose: Lower extremity amputations are commonly used in the field of orthopaedics to treat infections, trauma, and severe complications associated with diabetic foot ulcers. These procedures are often associated with high rates of unplanned reoperations, hospitalizations, and numerous postoperative complications. As a result, lower extremity amputations place added physical, emotional and financial stress on patients which can negatively impact outcomes. The aim of this study was to evaluate types of postoperative complications and the rate at which they occurred in an effort to improve future patient outcomes. Methods: Following institutional board approval, all patients at a single academic institution that underwent lower extremity amputation, by a single surgeon, from January 2017 to December 2020 were queried using hospital electronic medical records. Patient charts were followed from the date of surgery until their last follow up appointment in order to identify potential complications. Results: 135 patients underwent lower extremity amputation from 2017-2020. 102 were male (75.5%) and 33 were female (24.4%). The average age of the patients identified was 61.1. The oldest patient was 95 and the youngest patient was 13. The average number of days to a noted complication following amputation was 93.3. The earliest complication occurred 11 days after surgery, while the longest occurred 396 days. Of the 135 patients, 7 patients had revision of their amputation (5.2%), 4 had significant wound dehiscence (3%), 7 had delayed wound healing and excess fluid drainage (5.2%), 4 had postoperative infection (3%), and 4 were noted to have developed phantom limb (3%). Conclusion: Lower extremity amputations continue to be associated with high rates of postoperative complications. This data demonstrates that additional surgical revisions and delayed wound healing were the most common postoperative complications in our cohort.