{"id":"https://openalex.org/W4294350480","doi":"https://doi.org/10.1097/00003086-199007000-00013","title":"Limb Salvage Versus Amputation","display_name":"Limb Salvage Versus Amputation","publication_year":1990,"publication_date":"1990-07-01","ids":{"openalex":"https://openalex.org/W4294350480","doi":"https://doi.org/10.1097/00003086-199007000-00013","mag":"1989484338","pmid":"https://pubmed.ncbi.nlm.nih.gov/2194732"},"language":"en","primary_location":{"id":"doi:10.1097/00003086-199007000-00013","doi":"https://doi.org/10.1097/00003086-199007000-00013","is_oa":false,"landing_page_url":"https://doi.org/10.1097/00003086-199007000-00013","pdf_url":null,"source":{"id":"https://openalex.org/S191421250","display_name":"Clinical Orthopaedics and Related Research","issn_l":"0009-921X","issn":["0009-921X","1528-1132"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Orthopaedics and Related Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5039874831","display_name":"D. L. Helfet","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210106870","display_name":"Florida Orthopaedic Institute","ror":"https://ror.org/01tbvb523","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210106870"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"D. L. HELFET","raw_affiliation_strings":["Florida Orthopaedic Institute, Tampa, Florida"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Florida Orthopaedic Institute, Tampa, Florida","institution_ids":["https://openalex.org/I4210106870"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036719096","display_name":"Tom Howey","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210106870","display_name":"Florida Orthopaedic Institute","ror":"https://ror.org/01tbvb523","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210106870"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"T. HOWEY","raw_affiliation_strings":["Florida Orthopaedic Institute, Tampa, Florida"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Florida Orthopaedic Institute, Tampa, Florida","institution_ids":["https://openalex.org/I4210106870"]}]},{"author_position":"middle","author":{"id":null,"display_name":"R. SANDERS","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210106870","display_name":"Florida Orthopaedic Institute","ror":"https://ror.org/01tbvb523","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210106870"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"R. SANDERS","raw_affiliation_strings":["Florida Orthopaedic Institute, Tampa, Florida"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Florida Orthopaedic Institute, Tampa, Florida","institution_ids":["https://openalex.org/I4210106870"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5042855224","display_name":"K. JOHANSEN","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802336062","display_name":"Harborview Medical Center","ror":"https://ror.org/059jq5127","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2801852214","https://openalex.org/I2802336062"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"K. JOHANSEN","raw_affiliation_strings":["Department of Surgery, Harbor View Medical Center, Seattle, Washington"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Surgery, Harbor View Medical Center, Seattle, Washington","institution_ids":["https://openalex.org/I2802336062"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5036719096","https://openalex.org/A5039874831"],"corresponding_institution_ids":["https://openalex.org/I4210106870"],"apc_list":null,"apc_paid":null,"fwci":3.846,"has_fulltext":false,"cited_by_count":420,"citation_normalized_percentile":{"value":0.93999372,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":98,"max":100},"biblio":{"volume":"256","issue":"256","first_page":"80","last_page":"86"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":0.6996999979019165,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":0.6996999979019165,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11467","display_name":"Trauma and Emergency Care Studies","score":0.1680999994277954,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12117","display_name":"Muscle and Compartmental Disorders","score":0.04969999939203262,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/limb-salvage","display_name":"limb salvage","score":0.9039999842643738},{"id":"https://openalex.org/keywords/amputation","display_name":"amputation","score":0.7409999966621399},{"id":"https://openalex.org/keywords/mangled-extremity-severity-score","display_name":"Mangled Extremity Severity Score","score":0.9269999861717224},{"id":"https://openalex.org/keywords/lower-extremity-trauma","display_name":"lower extremity trauma","score":0.8730000257492065},{"id":"https://openalex.org/keywords/open-fractures","display_name":"open fractures","score":0.9760000109672546},{"id":"https://openalex.org/keywords/vascular-compromise","display_name":"vascular compromise","score":0.8500000238418579},{"id":"https://openalex.org/keywords/limb-ischemia","display_name":"limb ischemia","score":0.9259999990463257},{"id":"https://openalex.org/keywords/shock","display_name":"shock","score":0.5740000009536743},{"id":"https://openalex.org/keywords/prognostic-scoring","display_name":"prognostic scoring","score":0.6399999856948853}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9532045125961304},{"id":"https://openalex.org/C2776204877","wikidata":"https://www.wikidata.org/wiki/Q477415","display_name":"Amputation","level":2,"score":0.8561687469482422},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.5954241156578064},{"id":"https://openalex.org/C136948725","wikidata":"https://www.wikidata.org/wiki/Q1458306","display_name":"Soft tissue","level":2,"score":0.5696078538894653},{"id":"https://openalex.org/C85004164","wikidata":"https://www.wikidata.org/wiki/Q1089964","display_name":"Injury Severity Score","level":4,"score":0.507262647151947},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.5060326457023621},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.44293344020843506},{"id":"https://openalex.org/C68312169","wikidata":"https://www.wikidata.org/wiki/Q216685","display_name":"Orthopedic surgery","level":2,"score":0.4220721125602722},{"id":"https://openalex.org/C3017944768","wikidata":"https://www.wikidata.org/wiki/Q1450463","display_name":"Poison control","level":2,"score":0.27406197786331177},{"id":"https://openalex.org/C190385971","wikidata":"https://www.wikidata.org/wiki/Q373494","display_name":"Injury prevention","level":3,"score":0.2111445963382721},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.08848494291305542}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000671","descriptor_name":"Amputation, Surgical","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004630","descriptor_name":"Emergencies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007511","descriptor_name":"Ischemia","qualifier_ui":"Q000145","qualifier_name":"classification","is_major_topic":false},{"descriptor_ui":"D007511","descriptor_name":"Ischemia","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":false},{"descriptor_ui":"D007511","descriptor_name":"Ischemia","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":false},{"descriptor_ui":"D007866","descriptor_name":"Leg","qualifier_ui":"Q000098","qualifier_name":"blood supply","is_major_topic":false},{"descriptor_ui":"D007869","descriptor_name":"Leg Injuries","qualifier_ui":"Q000145","qualifier_name":"classification","is_major_topic":false},{"descriptor_ui":"D007869","descriptor_name":"Leg Injuries","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D007869","descriptor_name":"Leg Injuries","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011379","descriptor_name":"Prognosis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011446","descriptor_name":"Prospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013978","descriptor_name":"Tibial Fractures","qualifier_ui":"Q000145","qualifier_name":"classification","is_major_topic":false},{"descriptor_ui":"D013978","descriptor_name":"Tibial Fractures","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":false},{"descriptor_ui":"D013978","descriptor_name":"Tibial Fractures","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":false},{"descriptor_ui":"D015337","descriptor_name":"Multicenter Studies as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.1097/00003086-199007000-00013","doi":"https://doi.org/10.1097/00003086-199007000-00013","is_oa":false,"landing_page_url":"https://doi.org/10.1097/00003086-199007000-00013","pdf_url":null,"source":{"id":"https://openalex.org/S191421250","display_name":"Clinical Orthopaedics and Related Research","issn_l":"0009-921X","issn":["0009-921X","1528-1132"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Orthopaedics and Related Research","raw_type":"journal-article"},{"id":"pmid:2194732","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/2194732","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical orthopaedics and related research","raw_type":"Clinical Trial"},{"id":"mag:1989484338","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/2194732","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":"PubMed","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9476000070571899}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W1989484338","https://openalex.org/W4315927918","https://openalex.org/W2910367944","https://openalex.org/W2065148089","https://openalex.org/W2608266267","https://openalex.org/W1989252669","https://openalex.org/W4409676875","https://openalex.org/W2790203678","https://openalex.org/W4417234899","https://openalex.org/W2070385892"],"abstract_inverted_index":{"Objective":[0],"criteria":[1,67,192],"can":[2],"predict":[3],"amputation":[4],"after":[5],"lower-extremity":[6,58,117],"trauma.":[7],"The":[8,42,64],"authors":[9],"examined":[10],"the":[11,19,28,36,39,89,138,144,151,161],"hypothesis":[12],"that":[13,201,206],"objective":[14,191],"data,":[15],"available":[16,187],"early":[17],"in":[18,88,94,100,115,137,196],"evaluation":[20],"of":[21,27,169,190],"patients":[22],"with":[23,31,55,61,120],"severe":[24,57],"skeletal/soft-tissue":[25,75],"injuries":[26],"lower":[29],"extremity":[30],"vascular":[32,62,121],"compromise,":[33],"might":[34],"discriminate":[35],"salvageable":[37,203],"from":[38],"unsalvageable":[40,208],"limbs.":[41],"Mangled":[43],"Extremity":[44],"Severity":[45],"Score":[46],"(MESS)":[47],"was":[48,84,111,133,193],"developed":[49],"by":[50,212],"reviewing":[51],"25":[52],"trauma":[53,129],"victims":[54],"26":[56,116],"open":[59,118],"fractures":[60,119],"compromise.":[63],"four":[65],"significant":[66,86,135],"(with":[68],"increasing":[69],"points":[70],"for":[71,143,150,181],"worsening":[72],"prognosis)":[73],"were":[74,202,207],"injury,":[76],"limb":[77],"ischemia,":[78],"shock,":[79],"and":[80,98,148,163,204,209],"patient":[81],"age.":[82],"(There":[83],"a":[85,124,134,166,177],"difference":[87,136],"mean":[90,139],"MESS":[91,140,167],"scores;":[92,141],"4.88":[93],"17":[95],"limbs":[96,102,147,154,200],"salvaged":[97,146],"9.11":[99],"nine":[101],"amputated;":[103],"p":[104],"less":[105,156],"than":[106,157,171],"0.01).":[107,158],"This":[108,183],"scoring":[109,188],"system":[110,189],"then":[112],"prospectively":[113],"evaluated":[114],"injury":[122],"over":[123],"12-month":[125],"period":[126],"at":[127],"two":[128],"centers.":[130],"Again,":[131],"there":[132],"4.00":[142],"14":[145],"8.83":[149],"12":[152],"amputated":[153],"(p":[155],"In":[159],"both":[160],"prospective":[162],"retrospective":[164],"studies,":[165],"score":[168],"greater":[170],"or":[172],"equal":[173],"to":[174],"7":[175],"had":[176],"100%":[178],"predictable":[179],"value":[180],"amputation.":[182,214],"relatively":[184],"simple,":[185],"readily":[186],"highly":[194],"accurate":[195],"acutely":[197],"discriminating":[198],"between":[199],"those":[205],"better":[210],"managed":[211],"primary":[213]},"counts_by_year":[{"year":2026,"cited_by_count":5},{"year":2025,"cited_by_count":13},{"year":2024,"cited_by_count":10},{"year":2023,"cited_by_count":7},{"year":2022,"cited_by_count":7},{"year":2021,"cited_by_count":19},{"year":2020,"cited_by_count":19},{"year":2019,"cited_by_count":17},{"year":2018,"cited_by_count":10},{"year":2017,"cited_by_count":15},{"year":2016,"cited_by_count":19},{"year":2015,"cited_by_count":23},{"year":2014,"cited_by_count":24},{"year":2013,"cited_by_count":20},{"year":2012,"cited_by_count":18}],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2022-09-03T00:00:00"}