Patterns of extremity traumas leading to amputation in Iran: Results of Iranian National Trauma Project (original) (raw)

A survey on causes of amputation in a 9-year period in Iran

Archives of Orthopaedic and Trauma Surgery, 2012

Background Limb loss occurs as a result of different causes and has been increasing in many countries. This study determines the demography of amputees in one of the relatively large cities of Iran. Methods This retrospective study was undertaken on all of the amputees between 2003 and 2011. Patients' demographics including age, sex, the limb that had undergone amputation, etiology of limb loss and side and level of amputation were recorded. Also, the level of amputation was recorded as minor (below wrist or ankle) or major (above wrist or ankle). Results In total, 624 patients were enrolled in the study. The number of amputees was from 53 to 118/year. Of the patients, 508 were male (81.4 %) and 118 were female (18.6 %). The men with amputation were younger on average than women; 61.9 % of the amputations (386) were major and 38.1 % were minor (238). Overall, the most common cause of amputation was trauma and the most common level was transmetatarsal. The most common level for major amputations was below knee. Conclusion In contrast to similar studies in developed countries, trauma was found to be the major cause of all types of amputations and in all age groups, which emphasizes the need for preventive measures in the country.

Epidemiology and In-Hospital Clinical Outcome of Post Traumatic Limb Amputations in Lady Reading Hospital Peshawar

2017

Objective: To find out the epidemiology and in-hospital clinical outcome of post traumatic major limb amputations. Methods: This descriptive case series study was carried from February 2014 to June 2016. Life saving major limb amputations were performed in Accident and emergency Department (A & E) in patients of both gender and any age fulfilling the inclusion criteria. The demographic data and clinical data of mechanism of injury, level of amputation, associated injuries, Mangled Extremity Severity Score (MESS), postoperative stump wound infection, length of hospital stay and mortality were recorded. Patients were followed up till discharge from hospital. Results: A total of 82 patients(87 major limb amputations) with mean age 29 years (range 7 to 48 years) were enrolled in this study. Male patients were 77(93.9%) while female patients were 5(6%). Motor bike accident was accounted for the highest number of limb amputations (n=21, 24.1%) followed by sugar cane crusher machine (n=13,...

Epidemiology of the Upper Extremity Trauma in a Traumatic Center in Iran

Global Journal of Health Science, 2016

Introduction: Orthopedic injuries are the most common types of traumatic injuries and present as fractures of the limbs, pelvis, and vertebrae or lesions in soft tissues, muscles, ligaments, and tendons. The upper limb fractures occur in distal radius and ulna, metacarpals, fingers, scapula, and carpal bones, Proximal, diaphysis, distal humerus, clavicle, proximal ulna and radio and distal humero and humero, radio, ulna, and metacarpo. The objective of this project was to accurately describe the occurrence of injuries of the upper extremity and the mechanisms of such injuries in a representative sample of Iranian population. Method: This prospective case series was performed on the patients admitted to Shafa Yahyaian Hospital through the emergency ward within 6 months. Patients' demographic features, the information about the mechanism of injury in soft tissues, bones and joints which obtained using clinical examination and imaging techniques, also the findings during the surgery were recorded in the information form. All analyses were performed using SPSS software, version 21. The independent t test or Mann-Whitney test and the Chi-square test or Fisher's exact test was used to compare the data. The results were significant at P<0.05. Results: This study was performed on 1287 patients with upper limb fracture. The male and female patients respectively comprised of 998 (77.5%) and 289 (22.5%) subjects. About 113 patients suffered injuries at shoulder joint or its surrounding bones. The most common traumatic mechanisms in this group included falls from the standing position (49.2%), direct hit (19.5%), and then falling down (12.58%). Humerus fractures were observed in 68 patients. There was a significant correlation between humerus fractures and the mechanisms (P=0.000). The patients with traumas around the elbow comprised of 182 individuals. Sex distribution of fractures around the elbow shows a significant correlation between sex and elbow fractures. Forearm fractures were observed in 233 patients, and there was a significant correlation between age groups and forearm fractures. Fractures around the wrist were observed in 333 patients. There was a significant correlation between patients with fractures around the wrist (36.88±23.81 years) and patients without fractures (30.84±18.99 years) around the wrist in terms of the mean age. Hand fractures were observed in 358 patients. There was a significant correlation between hand fractures and sex. Conclusion: The result of the current study which shows the epidemiology of these injuries and how such injuries occur in this area can well help the healthcare planners to design preventive and therapeutic measures.

Global prevalence of traumatic non-fatal limb amputation

Prosthetics & Orthotics International, 2020

Background Limb amputation impairs physical functioning and mobility of people around the world. Leading causes of limb amputation have been reported to vary depending on region. Peripheral vascular disease and diabetes are commonly identified as the leading causes of limb amputation in highincome countries (HICs). 1-3 However, in many low-and middle-income countries (LMICs), trauma has been documented as the primary mechanism for limb amputation. 4-6 Trauma, and resultant limb amputation, has also been identified as a largely neglected epidemic in LMICs, warranting increased focus on both prevention and treatment. 7-9 To improve prosthetic rehabilitation for people with limb amputation, the World Health Organization (WHO) published new prosthetic and orthotic (P&O) service provision standards in 2017. 10 These guidelines highlight four

Üst Ekstremite Yaralanmalarına Bağlı Gelişen Dijital Amputasyonlar: Acil Servise Başvuran Hastaların Geriye Dönük Analizi

Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi

This study aimed to examine the characteristics of traumatic minor digital amputations in patients presenting to the emergency department, who were candidates for replantation and revascularization and to discuss the clinical outcomes of these patients. Upper extremity total/subtotal amputation cases presenting to Private Erzurum Buhara Hospital emergency department between January 1, 2018, and January 1, 2021, were retrospectively evaluated. The demographic characteristics, occupational status, etiology and type of injury, localization and level of injury, time to arrive at hospital and undergo surgery, length of hospital stay, and survival outcomes were recorded for a total of 134 patients. Of the patients, 88.1% were male, and the mean age was 36.45±20.87 years. Injuries were most commonly seen in those working in agriculture, at a rate of 61.4%. The most common injury type was avulsion (45.5%). The most common specific cause (16.4%) was related to throttle belt use. The mean tim...

Incidence and type of complications following traumatic extremity amputations: preliminary report from a teaching hospital

Amputation is one of the oldest surgical procedure and a good amputation results in optimal functional outcome by providing healthy residual limb. Advances in prosthetics has enabled amputee with diverse options and better functionality. There is also decrease in the overall burden of amputation as a result of better treatment of causative disorders and proper limb salvage techniques. Complications, however, pose challenges in regain of necessary functions and include an array of disorders related to the procedure, technique and other factors. An understanding of common and practical complications is helpful in their anticipation and relevant prohibitive measures. Apart from it, a comprehensive study that highlights pattern of amputations and related complications provides database for preventive and management strategy. A total of 69 cases of extremity amputations were included within a defined period of Jan 2011 to June 2016. Relevant demographic data were noted along with other details amputation and complications. An attempt is also made for co-morbidities associated in cases with complications. Males (88.40%) and lower extremity (66.66%) were involved more commonly than females and upper extremity. Below knee was commonest (50.72%) lower and below elbow along with digital amputations were commonest (15.94% each) upper extremity amputations. The significant complication that required increased hospital stay or additional procedures were noted in 34 (49.27%) cases. Delayed wound healing, wound dehiscence, painful neuroma, stiffness, exposed bone and phantom pain were some of major complication noted in the study. A brief notes on patient characteristics has been attributed to the nature of trauma, co-morbidities and substance abuse among the complicated cases. The early recognition of complication and prompt management goes a long way in abetment of agony and discomfort of patient affecting overall outcome.

Demography and Clinical Consequences of Trauma-Related Amputations in the Emergency Department Short

Journal of Academic Emergency Medicine, 2013

Objective: Total or subtotal traumatic extremity amputations constitute a considerable portion of trauma-related emergency department admissions. In this study, we aimed to establish the patients' age group, educational level and occupational group in which trauma-related extremity amputations are more frequently performed. Material and Methods: Cases presenting to our Emergency Department between August 2006 and August 2008, in whom traumatic extremity amputations were performed were prospectively studied. The data that were recorded on a study form, which included age, sex, educational level, occupation, mechanism of the trauma and hospitalization duration, underwent evaluation. Results: The data of 309 subjects were evaluated in this study. The mean age of the patients was 29±17.9, with 18.1% of the subjects being female and 81.9% being of male gender. 41.1% of the cases were laborers, 23.6% were self-employed in various fields, and 9.4% were farmers. With respect to the method of trauma in the majority of the amputations, industrial injuries accounted for 65.7%, finger jamming (door-related) accounted for 17.2%, and home injuries accounted for 8.7%. Finger amputation was identified in 93.4%, toe amputation in 4.4%, and "others" in 2.2%. Conclusion: Traumatic amputation concerns particularly children, youths, and people of low educational level with an active work life. The most frequently affected body parts are the fingers. (JAEM 2013; 12: 205-10) Özet Amaç: Total veya subtotal travmatik ekstremite amputasyonları travma ile ilişkili acil servis başvurularının önemli bir bölümünü oluşturmaktadır. Bu çalışmada, hastaların yaş, meslek, eğitim düzeyleri ve travma ile ilişkili ekstremite amputasyonlarından hangisinin en sık görüldüğünü tespit etmeyi amaçladık. Gereç ve Yöntemler: Çalışmada Ağustos 2006-2008 tarihleri arasında acil servise başvuran travmatik ekstremite amputasyonlu olgular prospektif olarak incelendi. Yaş, cinsiyet, eğitim düzeyi, meslek, travma mekanizması ve hastanede kalış süresi değerlendirildi. Bulgular: Bu çalışmada 309 olgu değerlendirildi. Hastaların yaş ortalaması 29±17,9 iken bunların %18'i kadın ve %82'si erkek idi. Olguların %41,1'i işçi, %23,6'sı serbest meslek ve %9,4'ü çiftçi idi. Amputasyonlar oluş mekanizması açısından değerlendirildiğinde, iş kazaları %65,7, parmak sıkışması (kapıya) %17,2 ve ev yaralanmaları %8,7 oranında sorumluydu. %93,4'lük parmak ampütasyonunun, %4,4'ünü ayak amputasyonu ve %2,2'sini de diğerleri oluşturmaktaydı. Sonuç: Travmatik amputasyonlar başta çocuklar, gençler, aktif bir çalışma hayatı olan ve eğitim düzeyi düşük insanlarda daha sık görülmektedir. En sık etkilenen vücut parçası olarak parmaklar tespit edilmiştir.