Lower Limb Amputations, Indications and Outcome

Amna Usman, Samar Fatima, Sana Shafique

Abstract


Objective: This study was carried out to determine indications of lower limb amputations and its out-come and complications.

Study design and Duration: It is a prospective type of study.

Setting: This study was conducted

Patients and Methods: Total 75 cases were studied. These cases were reported in emergency department and out- patient doors. Some of them underwent amputations on emergency basis due to septicemia and deep infections causing threat to life. Mostly cases underwent amputation on elective basis. These cases were admitted in the ward. All necessary investigations were carried out and they were evaluated for anesthesia fitness. On emergency basis operation was done in emergency department and elective amputations were done in main operation theater. A written consent was taken from all patients and also from the medical superintendant of the hospital for conducting this study. A proforma was designed for documenting presenting complaints, cause of amputation, total hospital stay, Outcome and complications after operation. After discharge from the ward these cases were called for follow-up and stump was examined for necrosis, infection or hematoma etc. All data was analyzed using Microsoft office and SPSS version 2007. Results were calculated in the form of frequencies and expressed via tables and graphs.

Results: Out of 75 cases 28(37.3%) cases underwent amputation of lower limbs on emergency basis and 47() cases were operated on elective basis. Ages of these cases was ranging from 30-75 years with mean age of 45.7 years. Mostly cases were above 40 years of age. There were 11(14.7%) cases with age range of 30-40 years, 17 with 41-50 years, 28 between 51-60 years, 7 cases between 61-70 years and 12 cases with age above 70 years. There were both male and female populations in this study group. There were 60(80%) males and 15(20%) female patients. It was seen that in most of the cases right limb was involved more than left limb. In 72% cases right lower limb and in 28% cases left lower limb amputation was done. There were different causes of amputation such as in 32 cases diabetes was cause, in 18 cases trauma, in 20 cases acute vascular insufficiency and in 5 cases infection was cause of lower limb amputation. Leading cause was diabetic foot. Most common complication seen after operation was wound infection seen in 23 cases, wound hematoma in 6 cases and stump necrosis in 3 cases was found. Out of 75 pos operative cases 50 were discharged, 15 were referred, 7 cases left against medical advice and 3 cases died due to septicemia and multi organ failure.    

Conclusion: Lower limb amputation is most commonly performed amputation. Main cause of amputation is diabetic foot leading to osteomylitis. Common post operative complication is wound infection. Lower limb amputation is a life saving procedure in most cases. Incidence of this amputation can been decreased by controlling causative factors and limiting the disease in early stages.

Keywords


Lower limb amputation, diabetic foot, Indications of amputation

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