Answer:
This paper, "Microvascular soft-tissue transplantation of acute open tibial fractures: timing of coverage and long-term functional results," has a mixed conclusion.
1) The rehab costs after limb slavage is high: initial fee plus other costs for equipment, therapy, future hospitalizations, travel.
2) Though most patients are content with their salvaged limb, persistent limitation of function exists in 80%.
3) Only 26% of patients were employed post-op. None returned to work after two years if they had not already done so..
4) This is compared to lower extremity amputations where 93% are succesfully rehabilitaed and 80% return to school or employment (80% of the patients in this series who underwent BKA were employed).
But the authors do not think that the initial salvage index should be based on “immediate reversible physical findings and not employment or probablility of reemployment.”