Outcomes of lower limb amputees at Cotonou

Abstract

Background: Limb amputations are responsible for disability. We studied the outcomes of lower limb amputees in our daily practice. Methods: This prospective analytical study over 7 years (January 2009-December 2015) included 70 amputees of lower limb. They were mainly male (73%), aged on average of 42.4 AE 18.8 years. The mean time of follow-up was 3.2 AE 1.9 years. We assessed disability on balance, walking, disability in daily life for patients with prosthesis, and the socioeconomic impact of the amputation. Statistical analysis was performed with Chi 2 and Mann-Whitney tests; a p-value 0.05 was considered statistically significant. Results: The average Timed Up and Go Test was 18.5 s. Class II of Pohjolainen subjects were the most recovered (37%). The mean Houghton score in the 17 fitted patients was 6.2 AE 2.0. Socially, 90% of the patients no longer practiced leisure activities, and 4/53 patients were no longer in a couple. At the economic level, 87% of patients had a decreased monthly income. Factors that bear direct correlation to functional outcome of patients were the level of amputation, and the prosthesis fitting. Conclusion: Lower limbs amputations entail adverse consequences at the functional and socioeconomic level. Our country must review its policy on prosthetic fittings for amputees, and vote laws that involve private firms and government in socioeconomic reintegration, and empowerment of these subjects.

Reamputation rates, morbidity and rehabilitation after lower limb amputations

“…Prosthesis fitted patients were more independent on walking than unfitted patients. 5 In this study out of 54 major LLAs, only 20 patients came up for prosthesis and overall 52.17% were able to mobilize.…”

“…Chigblo et al reported age range of 15 to 84 years in patients undergoing amputation with mean age 42.4 years. 5 Edison et al studied trauma patients and reported mean age among male patients 42.3 years and 47.5 years among female patients. 6 The elderly and the younger patients had peripheral vascular disease and trauma related amputations respectively, whereas the middle aged had diabetic foot.…”

“…This study is in harmony with the other studies with male preponderance with male-female ratio of 3.1:1. [5][6][7] Chigblo et al found trauma (70%) as the major cause of LLA followed by diabetic foot (21%) and peripheral vascular disease in his study. 5 Willey et al studied on peripheral vascular disease and concluded 52.8% patient underwent revascularization and 41% underwent amputation who developed chronic limb ischemia.…”

“…[5][6][7] Chigblo et al found trauma (70%) as the major cause of LLA followed by diabetic foot (21%) and peripheral vascular disease in his study. 5 Willey et al studied on peripheral vascular disease and concluded 52.8% patient underwent revascularization and 41% underwent amputation who developed chronic limb ischemia. 8 In the present study out of 27 patients of atherosclerosis, 6 patients underwent revascularization prior to the final decision of amputation.…”

Limb Salvage for Musculoskeletal Tumors in the Austere Environment: Review of the Literature With Illustrative Cases Regarding Considerations and Pitfalls

“…In multiple studies from low-income and middle-income countries, cancer is among the top four reasons for amputation. 38 39 40 41 Basic function is the typical goal for a patient in the resource-limited environment. Unfortunately, the rate of prosthesis fitting after lower extremity amputation can be as low as 24%.…”