Limb Amputations in a Tertiary Care Hospital, North India: A Cross-sectional Epidemiological Study - Can We Prevent This?

Background: Disability due to limb amputations is a major but preventable public health problem that is associated with profound economic, social, and psychological effects on the patients and their families, especially in developing countries where the supportive (prosthetic) services are meager or almost absent. The purpose of this study was to outline the patterns and indications for limb amputations in a tertiary care center of northern India and to compare our experience with that of other published data. Materials and Methods: This was an observational study conducted at a tertiary care hospital in northern India. All the patients who underwent limb amputations at this hospital between January 2018 and April 2020 were included in the study. Results: A total of 37 patients underwent various amputations during the study period. The age group ranged between 12 and 80 years (mean of 54.9 years) and the most effected age group was between 50 and 60 years (45%). Males outnumbered females with a ratio of 4: 1. When the pattern of amputations was studied, 34 were lower limb amputations and 3 were upper limb amputations. On subcategorization, 45% underwent below-knee amputations followed by above-knee amputations (29%). Diabetes mellitus was the most common cause, followed by trauma and peripheral arterial disease. Conclusion: Complications of diabetic foot ulcers and trauma resulting from road traffic accidents were the most common indications for major limb amputation in our study. Implementation of comprehensive care for diabetes by multidisciplinary approach via diabetic clinics at all the hospitals can help in reducing the complications of diabetes thus reducing the disability due to amputations. Road traffic accidents can also be reduced or prevented by implementing stricter laws and increasing the social awareness.