Changing trends for lower limb amputations in developing world
Journal Title: MedPulse -International Medical Journal - Year 2014, Vol 1, Issue 4
Abstract
Background Aims Purpose: To find out changing trend in indications of lower limb amputations and their impact on society specifically patients from lower economic strata in developing world. Study Design: Case series Case Description and Methods: Study was carried out in Department of surgery, Govt medical college and hospital, Nagpur, INDIA. from July 2008 to October 2013. Total 404 patients had lower limb amputation. Main outcome measures were patient’s age, gender, limb affected, indication of amputation and percentage of disability, complications, associated procedure performed. Findings and Outcome: Total 404 patients had lower limb amputation with mean age of 45 years with significant higher percentage in males (77.97%). Most common indication of amputation was diabetes mellitus 137(33.91%), peripheral vascular disease 127(31.43%), followed by trauma 65(16.08%) and tumour 44 (10.89%), with rare causes such as gas gangrene, burns, leprosy, osteomyelitis, etc. Tendency was to conserve knee with below knee to above knee ratio of 1.8:1 initially which changed to 1.21:1 after redo amputation. Prosthesis was offered to 160 (39.60%) patients from this institute, having good quality of life, other patients preferred crutches , some have preferred prosthesis from other physiotherapy centres. There was lesser morbidity, improved quality of life with better prosthetic fitting in patients of below knee amputation. Conclusion: Diabetes mellitus is leading indication of lower limb amputation and there is persistent increase in amputation because of Trauma with relative decline in number of amputations because of peripheral vascular disease indicating a changing trend. Clinical Relevance: Understanding this changing trend, lower limb amputations can very well be reduced by taking general precautions like foot care, control of blood sugar and road safety measures, it will reduce the morbidity and loss of man power.
Authors and Affiliations
Hedawoo J B, Mehsare P S, Shahane S, Jadhav S
Keywords
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