RT Journal
A1 Taylor, Benjamin C.
A1 Poka, Attila
A1 French, Bruce G.
A1 Fowler, T. Ty
A1 Mehta, Sanjay
T1 Gritti-Stokes Amputations in the Trauma PatientClinical Comparisons and Subjective Outcomes
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD April 4
VO 94
IS 7
SP 602
OP 608
DO 10.2106/JBJS.K.00557
UL http://dx.doi.org/10.2106/JBJS.K.00557
AB Background: 
  The Gritti-Stokes amputation procedure is a modification of the traditional transfemoral amputation, with resection of the bone at a supracondylar femoral level and fixation of the patella to the distal part of the femur as an end-cap. Although well-established in patients with vascular compromise, no evidence exists on its use in the trauma setting.Methods: 
  Fourteen consecutive patients who underwent Gritti-Stokes amputation and fifteen consecutive patients who underwent traditional transfemoral amputation by fellowship-trained orthopaedic traumatologists at a level-I trauma center were evaluated at more than fourteen months postoperatively. The Sickness Impact Profile (SIP) questionnaire was also administered to both patient groups at more than thirty-six months postoperatively to assess patient-reported functional outcomes.Results: 
  Despite the two groups not having significant differences in preoperative variables or demographics, the Gritti-Stokes group had significantly improved SIP questionnaire overall and domain scores. This procedure also left the patients with a significantly longer residual limb (an average of 46.1 cm of residual femoral length versus 34.6 cm for the transfemoral group). The Gritti-Stokes group also had a significantly increased rate of walking without assistive devices (five patients versus none in the transfemoral amputation group).Conclusions: 
  The Gritti-Stokes amputation appears to be safe and beneficial when utilized in the trauma population.Level of Evidence: 
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.