EPIDEMIOLOGY OF AMPUTATION;

Low resource community: Sindh Province, Pakistan (october 2007- june2012).

Abstract

Amputation is stated to be a foremost but preventable community health problem causing intense financial, social and
emotional effects on the patient and family particularly in developing countries where the prosthetic services are limited. The purpose of
this study was to identify the causes and levels of amputation in low resource community, Sindh Pakistan. Methods: This was a
retrospective chart review study that was carried out at first civilian Institute of physical medicine & rehabilitation-Dow University of health
sciences from October 2007 to June 2012. After verbal informed consent all patients, who underwent major or minor amputation were
enrolled for the study. Data was collected using a pre-tested, coded questionnaire and analysed using SPSS version 16. Results: A total of
1115 patients were enrolled into the study. Their ages were ranged between 2–95 years (mean 38.40±17.38). Among total population of
amputees 83.58% were males. The most common cause for major limb amputation was road Traffic accident 38.38%, followed by
Diabetes 15.42%, infection 14.26% and trauma 12.37%. Lower limbs (trans-tibial) amputations were in 47.35% of cases and transfemoral
in 27.98% of cases. While for the upper limb trans-radial amputation (7.4%) were found to be more common than trans-humeral
(5.56%). Other amputations were for shoulder, hip and knee disarticulations. Conclusions: Road traffic accidents, complications of
diabetic foot ulcers, infections and trauma were the most common causes for major limb amputations found in low resource community,
Sindh Pakistan. The majority of these amputations are preventable by endowment of traffic rules, health education, early preventions and
appropriate management of the common infections.