Management of mangled extremities

Abstract

Mangled extremities are high-energy injuries and are frequently associated with life-threatening systemic trauma. These injuries have severe bone and soft tissue involvement and are often complicated with other risk factors such as degloving of the skin, crushing of soft tissues, severe contamination and injury to neurovascular structures and hence carry a high risk for complications and amputation. Although advances in management of systemic injuries, availability of antibiotics, refinement in debridement techniques and bone and soft tissue reconstruction have helped salvage rates, the challenge to restore function and cosmesis as much as possible is still present. One should remember that patients with a painful or deformed extremity are highly dissatisfied and unhappily prefer an amputation as opposed to a prolonged and expensive treatment.