Self-reported health outcomes and medical complications at 6- and 8-year follow-up after direct skeletal fixation in individuals with bilateral transfemoral amputations.
Diana Toderita, Charles Handford, Arul Ramasamy and 4 others
PMID 40637205WHAT IT FOUND
Physical health scores rose from median 29 before surgery to 47 at 6 years and 45 at 8 years in eight military veterans with bilateral transfemoral amputation after direct skeletal fixation and rehabilitation.
Mental health improved at 6 years but not at 8.
Key findings
01Physical health scores rose from a preoperative median of 29 to 47 at 6 years and 45 at 8 years after direct skeletal fixation and comprehensive rehabilitation.
02Mental health scores were higher at 6 years than before surgery after direct skeletal fixation and comprehensive rehabilitation, but at 8 years were not significantly different from before surgery.
03Nine of 16 residual limbs needed further surgery, two residual limbs were on long-term antibiotics, and one implant was removed.
STILL TO COME
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What it does not show
Only eight veterans were studied, and complete SF-36 data were available for six, so the results cannot be generalised to all amputees. There was no external control group; participants were compared with their own earlier scores, so time, rehabilitation, and surgery cannot be separated. The participants were military veterans with a median age of 27 years at surgery, generally younger and highly motivated, and they received intensive rehabilitation at a specialist centre, which may not reflect civilian amputee populations. Mobility data were available in only two participants at all three assessment points, so the study cannot link health scores to measured walking outcomes. The soft tissue revision rate may be affected by a learning curve because these were the first DSF cases at the centre.
Declared interests
The authors declared no conflicts of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not read the improved physical health scores as proof that direct skeletal fixation alone caused them. All participants also received comprehensive rehabilitation, and there was no control group, so the separate contribution of surgery, rehabilitation, and time cannot be separated.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →