Peripheral vascular disease - limb salvage or amputation

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S3.4 Peripheral vascular disease - limb salvage or amputation

Presented by Hong Kong College of Orthopaedic Surgeons

Chairperson: Dr Yan-kit Lam

Private orthopaedic surgeon

Speaker: Dr Shui-wah Man

FHKCOS, FHKAM (Ortho)

Department of Orthopaedics and Traumatology, Queen Elizabeth

Hospital

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Synopsis

Introduction : Lower limb ischemia has been a common clinical problem encountered in patients with peripheral vascular disease (PVD) managed by orthopaedic surgeons. Most of them will end up in lower limb amputations.

However, with recent advance in understanding and treatment modalities for PVD, some of these limbs become salvageable if blood supply to the distal limbs can be enhanced. Successful response to those newer vascular augmentation procedures can make the amputation level more distal resulting in better preservation of limb function.

Illustrations : The evaluation and diagnosis of lower limb arterial disease will be discussed. Case will be presented for the demonstration of the collaboration between various parties, namely, the orthopaedic surgeon, the interventional radiologist and the vascular surgeons, for their roles in the management of ischemic limbs. The decision of level of lower limb amputations by orthopaedic surgeons will also be discussed.

Conclusion : The management of peripheral vascular disease remains as a challenge to the different parties. With improvement in the diagnostic techniques and the collaboration of management of different specialties, our patients will have better chance of limb preservation and subsequent ambulatory functions.

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