Leg reconstruction, amputation compared

People whose mangled legs were reassembled by doctors had about the same amount of disability and distress two years later as those who had amputations, a study found.

Dr. Michael J. Bosse, lead author of the study, said the results convinced him a rigorous series of operations is worthwhile for most patients.

"If we can, we should reconstruct," said Bosse, whose report is in today's New England Journal of Medicine.

Other doctors said the results, will help them convince patients that they may be as well off with a quick amputation as with years of reconstructive surgery.

Reconstruction often requires more operations and longer hospital stays, and risks more complications, then amputation.

Bosse, a surgeon at Carolinas Medical Center in Charlotte, N.C., expected the study to show amputees recover faster than surgical patients.

What he found was that both groups had equally severe disabilities, pain and emotional problems. Only about half of each group had been able to return to work.

Bosse and his colleagues tracked 545 patients whose foot or leg injuries put them at high risk for amputation. Of those, 149 had a foot or leg amputated during their first hospitalization, 25 more started reconstruction but later underwent amputation and the rest were reconstructed.

Doctors make many unsuccessful attempts to repair legs because people cannot believe that losing a limb might be better than keeping it, Dr. Randy Sherman of the University of Southern California said.

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