Abstract
Fifty-one limbs of 46 patients (35 males, 11 females) who were referred to our department for amputation were studied for contents of the consultation, underlying diseases, the level of amputation, complications, prognosis and the ability to ambulate. Most subjects, 93.5%, suffered from vascular diseases such as arteriosclerosis obliterans (ASO), diabetes mellitus (DM) and Buerger's disease. Referral for amputation and perioperative management has increased in number while postoperative orthotics was more common in the past. The mean age was young in trauma patients and old in patients with vascular diseases. The majority of patients with ASO and ASO accompanied by DM were males ; however, among patients with DM there was no difference in sex. A considerable number of subjects with DM managed to avoid amputation by conservative treatments. Amputation was performed at the level of the thigh in most cases with ASO and below the knee in cases with DM. Cardiac and cerebrovascular complications were encountered in patients with ASO ; however, there was none in patients with Buerger's disease. Of the subjects who underwent amputation, 78.3% recovered becoming ambulatory with prosthesis and 71.7% were discharged. Of the 25 patients who were contacted after discharge, 90.9% were still ambulatory and patients without amputation showed no deterioration. Perioperative management by a rehabilitation physician, careful consideration for indication of amputation and thorough orthotics and follow-up are indispensable.
