A five-year audit of lower limb amputations below the knee and rehabilitation outcomes: the Durban experience

  • P Manickum University of KwaZulu-Natal
  • S S Ramklass University of KwaZulu-Natal
  • T E Madiba University of KwaZulu-Natal
Keywords: diabetes mellitus, lower limb amputations, physiotherapy, prevalence, rehabilitation

Abstract

Introduction: Lower limb amputation (LLA) due to diabetes mellitus (DM) is a growing epidemic worldwide.

Objectives: To determine the prevalence of LLAs at Addington Hospital from 2010 to 2014 and to explore the rehabilitation outcomes of amputees.

Design and setting: A retrospective chart review of LLAs below the knee was undertaken at Addington Hospital.

Subjects: Patients who underwent LLAs were filtered from theatre registers.

Methodology: A data collection sheet included demographic profile, diabetic status, level of amputation, limb orientation and rehabilitation outcomes.

Outcome measures: Study endpoints were prevalence, compliance and rehabilitation outcomes.

Results: From 2010 to 2014, 767 LLAs in 667 patients were identified. Mean age was 59 (13.2) years. M:F ratio was 1:1. Of these, 354 patients (53.1%) had DM. Level of amputation was below-knee 57%, trans-metatarsal 12.4% and toectomy 30.6%. Only 116 patients (17.4%) were referred for physiotherapy, of whom 95 (81.9%) attended. Median frequency of physiotherapy visits was five and four for diabetic and non-diabetic amputees respectively. Mobility after rehabilitation was with a walking frame (49%), crutches (32%), prosthesis and crutches (8%), wheelchair-bound (9%) and independent gait (1%). 

Conclusion: Over half of amputations were associated with DM. The gender incidence was similar. Referral to physiotherapy and adherence thereto was poor.

The full article is available at https://doi.org/10.1080/16089677.2018.1553378

Author Biographies

P Manickum, University of KwaZulu-Natal

School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

S S Ramklass, University of KwaZulu-Natal

School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

T E Madiba, University of KwaZulu-Natal

Department of General Surgery, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

Published
2019-07-21
Section
Research Articles