Abstract
Blackfoot disease is an endemic peripheral vascular disease due to long term consumption of high arsenic and fluorescent content water from artesian wells among the inhabitants of southwest coast of Taiwan which causes gangrenous change of the limbs, especially of the lower extremities. Eventually, the patients undergo amputation resulting in disability that need rehabilitation.
A rehabilitation program including free supply of prostheses was started by the end of 1971 by National Taiwan University Hospital under the support of regional government. From 1971 to 1986, a total of 323 amputees, 219 males and 104 females, with average age 59.66 years (6-87-year-old in range), has been supplied prostheses and rehabilitated. Among them, 1.83 cases deceased, 45.7% of cases has been followed for more than 5 years, and 20.4% more than 10 years. Nearly two thirds (210 cases) of the patients were unilateral below-knee (BK) amputees and 57 cases (17.7%) were bilateral BK. There were 38 cases (11.8%) of unilateral above-knee (AK) amputees and 4 cases of bilateral AK. Five patients have been amputated at below-elbow level, with one who underwent amputation of all limbs finally. The acceptance rate of prostheses were varied from 71.1% to 85.5% at different surveys.
Our experience in successful rehabilitation for the amputees from Blackfoot disease provides a good model for western-Pacific countries in the management of amputees in rural areas.
