The Leg Amputee: A Clinical Follow-up Study

Abstract

Amputation is a mutilating and permanently disabling intervention after which rehabilitation is required to help the patient find his place in the world. In planning what measures are likely to be most effective for the rehabilitation of leg-amputees, it is important to know the magnitude of the patient's handicap as a result of the amputation. Against this background, the present investigation was designed to provide information on annual frequencies of leg-amputees in a Swedish urban population in the past, at present and in the future, on amputation rates, on causes of amputation, on postoperative mortality and survival time, and on the clinical and sociomedical function of patients various lengths of time after amputation at different ages. 5 CHAPTER 1 Definitions Leg-Amputee: a patient whose lower extremity has been amputated proximal to the ankle joint. Amputation Year: the calender year when the patient underwent the first amputation proximal to the ankle joint. Amputation Age: the patient's age at the time of the first amputation proximal to the ankle joint. Amputation Cause: the main disease or trauma that gives rise to a condition necessitating amputation. For example, the main disease is peripheral obliterative arteriosclerosis which leads to a condition, gangrene, which in turn calls for amputation. The amputation cause in this example is peripheral obliterative arteriosclerosis. Postoperative Complications: complications occurring during the six months following the first amputation proximal to the ankle joint. Duration of Treatment: the length of time elapsed from the day the patient was admitted to hospital to the day he was discharged. Amputation Level: denoting that the leg was amputated either below or above the knee. Patients whose hip or knee joint had been exarticulated were regarded as above-knee amputees. 8 Survival Time:, the time from the last amputation proximal to the ankle joint to the day of death. Prosthesis-Walker: a patient who, unaided by another person, has used his prosthesis daily for six months, with or without supporting himself on a cane. Clinical Function: in this context merely the patient's ability to use his prosthesis. Sociornedical Function: the patient's ability to benefit from his clinical function in daily life. 9 CHAPTER 2 Methods A list was prepared of all the 586 inhabitants of Gothenburg who had undergone leg amputations in Gothenburg over the years 1947 through 1962. Primary information was obtained from the operation schedules for the following departments: Departments of General Surgery I and 11, Extremital Surgery, Thoracic Surgery and Orthopaedics, all in Sahlgrenska Sjukhuset, and the Surgical Clinics of the Paediatric Hospital, Ekmanska Sjukhuset and Carlanderska Sjukhemmet. This group of 586 leg-amputees will hereinafter be known as the "586-Series". Occasionally supplementary data were extracted from case records. The information thus gathered made it possible to analyze the frequencies as well as the age and sex distributions of these leg-amputees. The...

Mortality After Major Amputation Following Gangrene of the Lower Limb

“…It is not only a matter of the strain imposed by more extensive surgery, but rather one of the general preoperative condition of the patient. This relationship between hospital mortality and the level of the amputation was also found by Robinson (1976), and the relation between the level of amputation and somatic complications was discussed in detail by Hansson (1964).…”

“…Only a few studies have considered the longterm prognosis €or lower extremity amputees (Hansson 1964, Christensen 1976. In these works a high mortality rate after amputation on the lower limb was observed.…”

Diabetic amputees in Singapore.

“…Peripheral vascular disease accounted for 49-86% of cases. In the Western world, diabetes accounts for about 50% of amputations of the lower extremity because of gangrene14, 15,16). In the present study, diabetes accounts for 59.2% of the causes for amputations in the Singapore General Hospital.…”

Age, Diabetes and Smoking in Lower Limb Amputation for Arterial Occlusive Disease

“…Diabetics are younger at amputation in most studies (Hansson 1964, Hierton 1973, Christensen 1976. Otteman (1965), however, found that the diabetic patients were an average of 4 years older among 323 leg and foot amputees.…”