{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:09:41Z","timestamp":1790546981539,"version":"4.1.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Summary:<\/jats:title>\n                  <jats:p>Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18\u201360 years with severe distal tibia, ankle, and foot injuries. This study aims to build upon the previous work of the Lower Extremity Assessment Project by identifying the injury and patient characteristics that help define a subgroup of salvage patients who will have better outcomes had they undergone a transtibial amputation.<\/jats:p>","DOI":"10.1097\/bot.0000000000000799","type":"journal-article","created":{"date-parts":[[2017,3,23]],"date-time":"2017-03-23T02:34:35Z","timestamp":1490236475000},"page":"S48-S55","source":"Crossref","is-referenced-by-count":47,"title":["Outcomes After Severe Distal Tibia, Ankle, and\/or Foot Trauma: Comparison of Limb Salvage Versus Transtibial Amputation (OUTLET)"],"prefix":"10.1097","volume":"31","author":[{"given":"Michael J.","family":"Bosse","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Carolinas Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Teague","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Oklahoma College of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Reider","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua L.","family":"Gary","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, McGovern Medical School at UTHealth Houston;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saam","family":"Morshed","sequence":"additional","affiliation":[{"name":"Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, University of California San Francisco;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel B.","family":"Seymour","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Carolinas Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Toledano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Naval Medical Center San Diego;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa K.","family":"Cannada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Saint Louis University;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Steverson","sequence":"additional","affiliation":[{"name":"Orthopaedic Trauma Service, Tampa General Hospital, Florida Orthopaedic Institute; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel O.","family":"Scharfstein","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Luly","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen J.","family":"MacKenzie","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"METRC","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","first-page":"70","article-title":"Combat foot and ankle trauma","volume":"19","author":"Tintle","year":"2010","journal-title":"J Surg Orthop Adv."},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.fcl.2009.11.005","article-title":"The mangled foot and leg: salvage versus amputation","volume":"15","author":"Shawen","year":"2010","journal-title":"Foot Ankle Clin."},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1097\/00005131-199408000-00012","article-title":"Morbidity after crush injuries to the foot","volume":"8","author":"Myerson","year":"1994","journal-title":"J Orthop Trauma."},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/00005131-199206000-00012","article-title":"The salvage of open grade IIIB ankle and talus fractures","volume":"6","author":"Sanders","year":"1992","journal-title":"J Orthop Trauma."},{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/BOT.0b013e31825121b6","article-title":"The mangled foot and ankle: results from a 2-year prospective study","volume":"27","author":"Ellington","year":"2013","journal-title":"J Orthop Trauma."},{"key":"R6-20230828","doi-asserted-by":"crossref","first-page":"799","DOI":"10.2106\/00004623-198769060-00001","article-title":"The type-IIIC tibial fracture. 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