Epidemiological Trends of Lower Limb Amputation in Artificial Limb Centre
Abstract
Main aim of our study was to compose an inclusive report on the “Epidemiological Trends of the lower limb amputation in two different population groups”. This is a retrospective study carried out at Artificial Limb Centre (ALC), Pune from 1st February 2012 to 31st January 2016. A total of 3402 patients who had undergone the prosthetic rehabilitation at the ALC, Pune were included in our study. All the patients after initial assessment were divided into two groups, 1. Defence Personnel’s & Dependents 2. Civilian patients.
The patients were evaluated with respect to age, sex, aetiology, site, level and prevalence of amputation among the sexes at different ages and surgical interventions performed and It was found that the physical trauma was still one off the leading cause of major Lower Limb Amputation in developing countries, but new emerging causes like “Metabolic and Vascular” were showing the continuously increasing trends. The reason for this change was rise in the diabetes & its associated complications. This study is therefore intended to provide an insight into epidemiological trends of major lower limb amputation in army personal, dependents and general population.
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Introduction
The major limb amputation has been performed for injured/traumatic/neurologically and vascular compromised body parts for over 2,500 years from now. Previously Physical Trauma, Peripheral Vascular Diseases and Cancer were the prominent disorders, but now a day’s causative pattern has been shifted to Metabolic/Vascular disorders. Amputation which is being done for a wide range of nonhealing/infective/rapidly spreading disorders is affiliated with marked disability, morbidity and mortality.
The word “Amputation” originally came from a Latin word “amputare “which means “to excise/cut out” is generally described as the “removal of a part of the extremity or complete body part/parts covered with the skin”.1Amputation is associated with profound psychological, social and adverse outcome for the patient & his/her family members. It is also associated with marked disability, morbidity and early mortality particularly in countries where the acceptance and knowledge about the prosthesis is generally poor [2], [3]. In most of the underdeveloped countries prosthesis is generally not easily available, costly and not conducive to patient at home and his/her work environment. Above all poor prosthetic management leads to so many secondary complications like (Stump Edema, Pain, Infection and secondary vascular/neurological complications).
In developing countries particularly in younger population group Physical trauma, Infections and Malignancies [4] are few of the leading cause of amputation whereas in elderly population Uncontrolled Diabetes Mellitus induced Vascular/Neurological complications, Infections and malignancies are the principle reasons for major lower limb amputation.
Conclusion
Traumatic amputations was the leading causes of amputation in both army and civil population particularly in younger population in the past but now Metabolic and Neoplastic causes are replacing the existing traumatic cause. Metaobolic and Neoplastic causes are also appearing in young population group, so there is a strong need to control these problems at an early age to prevent future complication and irreversible loss of organs.