NON-TRAUMATIC LOWER LIMB AMPUTATIONS: EPIDEMIOLOGY, INDICATIONS, COMORBIDITIES, CLINICAL OUTCOMES, AND SPECIFIC ASPECTS OF POST-AMPUTATION REHABILITATION AND PROSTHETIC MANAGEMENT
DOI:
https://doi.org/10.11603/1681-2786.2026.2.16397Keywords:
lower limb amputation; diabetes mellitus; malignant tumors; peripheral artery disease; rehabilitation; prosthetics.Abstract
Purpose: retrospective collection and analysis of data on the prevalence, consequences, and prognosis of non-traumatic ANCs to create a practical basis that will help improve the results of treatment, rehabilitation, and prosthetics for patients in the future. Materials and methods. An analytical retrospective study of a series of cases was conducted during 2021-2024 in clinical institutions in Ukraine. The sample included 109 patients aged 35-71 years who underwent non-traumatic lower limb amputations. Demographic, clinical, and instrumental data, indications for amputation, level and type of intervention, concomitant diseases, frequency of complications, repeat operations, length of hospitalization, and early mortality were collected. Results: The main indications were diabetic gangrene of the foot (36,70%), malignant tumors (19.27%), and chronic neuropathic ulcers with osteomyelitis (16,51%). The most common level of amputation was below the knee (51,38%). Comorbidities included diabetes mellitus (36,70%), arterial hypertension (22,93%), and obesity (20,18%). Postoperative complications were observed in 11,92% of patients, reamputations in 8,25%, and early mortality in 3,67%, with all fatalities associated with uncontrolled diabetes. Patients with diabetes mellitus had a significantly higher incidence of infections, the need for repeat interventions, and reamputations. Most patients required multidisciplinary rehabilitation and prosthetics 6 weeks after surgery once their condition had stabilized. Conclusions. Non-traumatic lower limb amputations are most often associated with complications of diabetes mellitus, malignant tumors, chronic neuropathic ulcers, and peripheral artery disease. Diabetes mellitus significantly increases the risk of infections and repeat amputations. Early diagnosis, prevention, and optimal control of comor- bidities can reduce the frequency of major amputations. Comprehensive multidisciplinary rehabilitation and timely prosthetics are key factors in the successful social and functional reintegration of patients.
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