Akademik Veri Yönetim Sistemi
Ulusal Travma ve Acil Cerrahi Dergisi, cilt.31, sa.11, ss.1137-1142, 2025 (SCI-Expanded, Scopus, TRDizin)
In cases of traumatic major extremity amputations, particularly ofthe lower extremity, every stage—from decision-making to implementation and outcomes—remains a matterof debate. Managing such cases, which carry high mortality rates, is extremely challenging both at the time of injury and throughout treatment. We present a rare and severe case of a 30-year-old patient who sustained injuries from a concrete machine, resulting in bilateral lower extremity amputations and a unilateral proximal arm amputation. A replantation was successfully performed at the proximal ankle level on one side. Our patient has been followed for 14 years, during which we achieved a satisfactory outcome through meticulous surgical intervention, evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) and Maryland foot scores. We attained a limb with intact plantar sensation and near-complete range of motion in the ankle and toe joints. Although the clinical application of the Mangled Extremity Severity Score (MESS) score has established criteria for replantation in traumatic amputation cases, we believe there maybe relative indications for limb salvage, particularly in cases of multiple traumatic amputations, especially bilateral lower extremity amputations. In such injuries, the patient's life should be prioritized. Subsequently, at least one amputated extremity and its stump should be thoroughly evaluated. Rather than opting for stump closure, we advocate attempting replantation.