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 & Methods: Study was carried out in Government Medical College, Nagpur from July 2008 to March 2011. Total 250 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 & outcome: Total 250 patients had lower limb amputation with mean age of 45 years with significant higher percentage in Males (80%) . Most common indication of amputation was Diabetes mellitus 85(34%) & peripheral vascular disease 85(34%), followed by Tumour (15.60%), Trauma 30(12%), with rare causes as Gas gangrene, Burns, Leprosy, Osteomyelitis. Tendency was to conserve knee with BK to AK ratio of 1.8:1 initially which changed to 1.21:1 after redo amputation. Prosthesis was offered to 31 (12.4%) patients having good quality of life. 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, foot care, control of blood sugar and road safety measures, reducing the morbidity and loss of man power.

Description