Demographics of Lower Limb Amputations in the Pakistan Military: A Single Center, Three-Year Prospective Survey

Abstract

Introduction The Pakistan military has been actively engaged in the war against terror for more than a decade. Many officers and soldiers have lost their limbs in this war. But the data on traumatic lower limb amputations in Pakistan is sparse. The aim of this study is to prospectively document the epidemiological profile of lower limb military amputees presenting at the largest rehabilitation centre of Pakistan over a three-year period.Materials & methods A prospective three-year survey was conducted at the Armed Forces Institute of Rehabilitation Medicine (AFIRM), Pakistan. One hundred twenty-three consecutive patients with lower limb amputations were enrolled in the survey. The demographic data, etiology, associated injuries, complications profile, and type of prosthesis provided were documented. The data analysis was done using the statistical analysis tool SPSS V 20 (IBM®,NY, USA). Results All patients were male. Most had traumatic amputation (119), were between 20–40 years (106), with unilateral amputation (115). Mine blast injury was the leading cause in 73 (59.3%) and most (58.5%) were fitted with modular prosthesis. Transtibial amputation was the commonest level (65), followed by transfemoral (30). The time of surgical amputation was not documented in 87% of the patients. Half of the patients (54%) had associated injuries. Seventy-nine patients had at least one complication with phantom pain being the commonest in 25% cases.Conclusions This is the largest prospective demographic survey of lower limb amputees in Pakistan military to date. Scores of soldiers and civilians in Pakistan have suffered lower limb amputation. The availability of demographic data can improve the trauma and rehabilitation services for better understanding and management of such cases. There is a need to conduct large scale community-based epidemiological surveys to direct future policies and develop amputee rehabilitation services in the public sector.

Pattern of limb amputations in Liberia

“…This prevalence is consistent with what was obtained in other studies around the region. [12715] Like most global reports, lower limb amputations are more are more (92%),[19121416] with below knee slightly more than above knee 47 and 45, respectively. This is largely similar to what was obtained in majority of amputations obtained around the region.…”

“…This is consistent with most studies globally. [12712131416] The lower limb is particularly at risk of trauma, diabetic foot peripheral vascular disease. [124578] There was a prevalence of 100% unilateral amputation in our study.…”

“…This slightly differs with studies around the region whereby most have low but significant prevalence of bilateral amputations. [12791213141516] Diabetic-associated gangrene is the leading indication for amputation (29%). This is similar to what was obtain most studies around the region.…”

Incidence and type of complications following traumatic extremity amputations: preliminary report from a teaching hospital

“…[5] Traumatic amputations is common procedure in developed world with the road traffic accidents involving high velocity trauma a major contributor. Recent times has shown armed conflicts with use of land mines and explosives as a key contributor of war time injuries leading to amputations in affected regions [6] . We had no instances of amputation related to use of firearm related injury.…”

Levantamento dos problemas do dia a dia de um grupo de amputados e dos dispositivos de auxílio que utilizam

“…A maior parte dos entrevistados é amputado em um único membro, nível transtibial (78,6%). A amputação com esta característica é a mais realizada entre as amputações de membro inferior 1,15,16 . Dados apontados em outro estudo 17 relatam que nos Estados Unidos cerca de 1,3 milhões de pessoas são amputadas na extremidade inferior, e, dentre elas, 28% foram amputadas no nível transtibial.…”