(ii) The mangled extremity: limb salvage versus amputation

The best course of management for severe lower extremity trauma where the choice is amputation versus limb salvage/reconstruction remains enigmatic. There is now good evidence as to the costs, drivers of patient satisfaction, improved discriminators to choice and outcome. However, there still remains no good method or score to help in the final decision-making, and the ultimate verdict is influenced by the injury, patient, surgeon healthcare system and by the surrounding society. This paper gives some of the present evidence.