THE STATUS OF LOWER-LIMB AMPUTATION IN BANGLADESH - A 6-YEAR REVIEW

We conducted a review of 450 single lower-limb amputations performed i n our hospital in Bangladesh between July 1982 and June 1987, The inci dence of amputation in the specific area of 1 000 000 inhabitants cove red by the hospital was 0.75/10(3) per year, The indications for amput ation were: limb ischemia in 366 patients (81%), traumatic crush injur y in 45 (10%), diabetes-associated complications in 20 (5%), severe li mb infection in 10 (2%), and neoplasm growth in 10 (2%), The ratio of above-knee (AK) to below-knee (BK) amputation was 1:65, and 36 patient s (5%) required reamputation, 22 of whom had undergone BK amputation p reviously, Thus, the number of patients with a final amputation at AK level was 302 (67%), The operative mortality was 21% and the uncomplic ated primary wound healing rate was 89% within the survivors. Among th e 355 patients who survived the amputation, 265 (75%) were given a pro sthesis, 50 (14%) refused a prosthesis, and tile remaining 40 (11%) we re unfit for a prosthesis. Rehabilitation was successful in 44% of the AK and 86% of the BK amputees, In conclusion, when amputation is inev itable, maximum consideration should be given to the type of surgery p erformed to avoid rehabilitation failure.