Reamputation rates, morbidity and rehabilitation after lower limb amputations

Authors

  • Nishish Vishwakarma Department of Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
  • Babar Rehmani Department of Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
  • Atul Agarwal Department of Orthopaedics, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
  • Jitendra Prasad Ray Department of Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2349-2902.isj20191262

Keywords:

Lower limb amputation, Below knee amputation, Above knee amputation

Abstract

Background: This study attempted to document the indications for lower limb amputation (LLA) and its outcomes especially the wound healing problems, reamputations and subsequent use of prosthesis for mobilization in Indian population.

Methods: This observational study included 92 patients over a period of 18 months. Indications, level of LLA, morbidity and reamputation rates after LLA were recorded. Stump status, wound healing and other morbidity was followed over period of one month. The use of prosthesis and level of mobility were assessing in follow-up over a period of six months.

Results: There were total 109 LLA in 92 patients as some of these patients had to undergo revision of amputation stump at a higher level. Atherosclerosis (29.3%) was the main cause for LLA. Age group 35-55 years and male patients were most commonly needed LLA. Total 64.13% patients developed post-operative wound infection and 18.4% patients underwent reamputation. E. coli and Staphylococcus were the most common organism cultured from the infected surgical site. Conversion of below knee amputation (BKA) to above knee amputation (AKA) was the most frequent reamputation and atherosclerosis was the leading cause. According to final level LLA, 54 had major amputations (above ankle joint), only 37% were using a prosthesis whereas majority of patients were dependent on crutches/walker.

Conclusions: Patients of atherosclerosis and trauma had a higher frequency of reamputations. Only 37% of major LLA opted for prosthesis whereas majority of patients mobilize by other means like crutches or walker. 

Author Biography

Jitendra Prasad Ray, Department of Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India

Assistant Professor

General Surgery

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Published

2019-03-26

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Section

Original Research Articles