PURPOSE: The purpose of this study was to examine specific types of lower extremity injuries (LEI), their treatment, and trends in length of stay (LOS) as seen in an academic community hospital.

MATERIALS AND METHODS: Our trauma registry was queried for LEI requiring surgical intervention from1992 to 2000. A retrospective analysis was conducted to determine types of injuries, treatments rendered, time to closure, and LOS.

RESULTS: Of 5,567 patients identified, 574 patients with 857 injuries met the criteria. Despite a significant difference in ISS scores among the injury types only between traumatic amputations and open fractures (p=0.006), there was no statistical difference between these two groups with regard to LOS. Patients requiring one or two procedures had a significantly shorter LOS than those requiring three procedures (p=0.002 and p=0.021, respectively). Although free tissue transfers were utilized for primary closure in patients with the lowest ISS scores, there was no statistical difference in time to closure or LOS between free flaps and other major surgical procedures.

CONCLUSION: In these patients, the manner of initial reconstruction did not seem to impact LOS. LOS reduction might be possible when patients with lower ISS scores can be treated in a more expeditious manner.