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Gritti-Stokes Amputations in the Trauma Patient: Clinical Comparisons and Subjective Outcomes

Taylor, Benjamin C. MD; Poka, Attila MD; French, Bruce G. MD; Fowler, T. Ty MD; Mehta, Sanjay MD

Journal of Bone & Joint Surgery - American Volume: 4 April 2012 - Volume 94 - Issue 7 - p 602–608
doi: 10.2106/JBJS.K.00557
Scientific Articles

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.

1Department of Orthopedic Surgery, Grant Medical Center, 285 East State Street, Suite 500, Columbus, OH 43215. E-mail address for B.C. Taylor:

2Department of Orthopedic Surgery, Mount Carmel Medical Center, 793 West State Street, Columbus, OH 43222

Copyright 2012 by The Journal of Bone and Joint Surgery, Incorporated
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