Home|Journals|Articles by Year Follow on Twitter

Directory for Medical Articles
 

Open Access

Original Research

Ulutas Med J. 2016; 2(4): 166-175


A Study of Ambulatory Function and Complications in Adult Below Knee Amputees

Amit Saraf.

Abstract
Introduction: Inspite of development of new surgical techniques amputation has many complications. These complications may further be categorized into early and delayed complications. Amputation not only causes a physical disability to the patient, it also has an effect on his social economic and psychological conditions. We undertook the present study with an aim of assessing complications and ambulatory functions in below knee amputees.
Methods: 10 years study was done including a total of 174 patients. Patients were grouped into diabetics and non-diabetics based on the primary cause of amputation. Various complications which were assessed included hematoma formation, wound healing problems, infections, phantom limb/pain, contractures, etc. Ambulatory functions were assessed before surgery and at follow-ups using modified ambulatory scale by Pinzur et al 1983.
Results: 41 (28.5%) had edema of the stump. Of these patients 26 were in diabetes group. In 38 patients stump healing was prolonged with 21 patients in diabetes group and 17 patients in the non-diabetic group. 16 patients had wound dehiscence with 11 patients in diabetic group and 5 in non diabetic group. 15 (10.4%) patients developed contractures after below knee amputation, of which, 9 patients were in diabetic group and 6 were in non-diabetic group. In diabetes group, preoperatively 29 (46%) patients had grade 6 level of ambulation. In non-diabetics preoperative grade 6 was observed in 77 (95.1%) of patients. Post operatively 19 (30.2%) patients in diabetic group and 64 (79 %) patients in the non-diabetic group had grade 6 ambulatory scale. 35 in diabetic group and 44 in non diabetic group lost/ changed their job. 33 patients (78.6%) in diabetes group and 48 (62.3% ) in the non-diabetic group suffered an income loss. 34 (28.6%) had a psychological effect following below knee amputation. Of these 34, 10 patients were in the diabetic group and 24 were in the non-diabetic group.
Discussion: Haematoma formation is not significant but diabetics have a higher incidence of it in comparison to non-diabetics. Edema develops in less than one-third of the patients. Diabetics have a higher incidence of it. More than one-fifth of BK stumps gets infected, with diabetic preponderance. Wound dehiscence is common in BK amputation performed due to diabetes. There is a higher incidence of above-knee amputation after BK amputation in diabetics. Preoperative and postoperative ambulatory grade is poorer in diabetics in comparison to trauma patients. Diabetics require additional support besides using the prosthesis. Manual labor class is worst affected due to loss of job. People employed in clerical/ desk jobs have minor changes. Younger people have psychological impact commonly. The death rate is significant within one year of BK amputation and diabetics have a higher probability.

Key words: Ambulatory function, complications below knee amputees



Similar Articles

Neuroprotective effects of Alda-1 mitigate spinal cord injury in mice: involvement of Alda-1-induced ALDH2 activation-mediated suppression of reactive aldehyde mechanisms.
Khan M, Qiao F, Kumar P, Touhidul Islam SM, Singh AK, Won J, Singh I
Neural regeneration research. 2022; 17(1): 185-193

Gene and protein expression profiles of olfactory ensheathing cells from olfactory bulb olfactory mucosa.
Lan YX, Yang P, Zeng Z, Yadav N, Zhang LJ, Wang LB, Xia HC
Neural regeneration research. 2022; 17(2): 440-449

Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: a single-arm study.
Okawara H, Tashiro S, Sawada T, Sugai K, Matsubayashi K, Kawakami M, Nori S, Tsuji O, Nagoshi N, Matsumoto M, Nakamura M
Neural regeneration research. 2022; 17(2): 427-432

Genome-wide interrogation of transfer RNA-derived small RNAs in a mouse model of traumatic brain injury.
Xu XJ, Yang MS, Zhang B, Ge QQ, Niu F, Dong JQ, Zhuang Y, Liu BY
Neural regeneration research. 2022; 17(2): 386-394

High-frequency spinal cord stimulation produces long-lasting analgesic effects by restoring lysosomal function and autophagic flux in the spinal dorsal horn.
Wang ZB, Liu YD, Wang S, Zhao P
Neural regeneration research. 2022; 17(2): 370-377


Full-text options


Add your Article(s) to Indexes
• citeindex.org






ScopeMed.com
CiteIndex.org
CancerLine
FoodsLine
PhytoMedline
Follow ScopeMed on Twitter
Author Tools
eJPort Journal Hosting
About BiblioMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Bibliomed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
ScopeMed is a Database Service for Scientific Publications. Copyright ScopeMed Information Services.