The Main Reasons For Lower-Extremity Amputation

From the National Health Interview Survey (NHIS) in 1996, there are 1. 2 millions patients lose their upper or lower limbs. The estimation of growing amputation is 185000 objects in United States every year. One of the estimation for people losing limbs is 2. 1 million amputees and is expected to double by the year 2050 in United States. The number of amputations resulting from diabetes increased by 24% from 1988 to 2009. Another estimation is the number may grow three-times in 2050 from 1. 6 millions in 2005. The estimation method is based on Brookmeyer and Groy. The reasons for the amputation are diabete mellitus, vascular diseases, injury, bone cancer in joints or extremity and birth defects [1,2 & 3]. The main reason of amputation is Diabete Mellitus (DM) since they are more than 60% of lower-leg amputations in the medical record. When the age increases in United States, the rate of amputation is expected to be higher than before.

Reasons for amputation

Diabetes Mellitus

DM is the first reason for amputation. DM is a long-term disease especially, type two diabetes, and it causes a metabolic syndrome. Moreover, it results in vascular complication in both micro and macro aspects. There are many reasons for the type two diabetes developing to lower extremity amputation (LEA), a surgery to eliminate the component of lower limbs. Age, time for the disease, smoking, or drinking alcohol will affect patients having type two diabetes to process LEA (E). All of those complex factors may cause a gradually but seriously long-term result: diabetic neuropathy (DN). DN relates 50% to 75% of non-injury amputation. Foot ulceration, a syndrome when DN happens, is the indication of risk for amputation. The patients has 1. 7 degree of risk for resulting amputation if they have DN. Once the lower or upper-extremity deformed, it will increases to 12, and if the patients have the history of foot ulceration, then the risk is 36. Another research supports for the risk analysis. If the patients have a foot ulceration and fail to treat it, they will have the high possibility to have LEA.

Cancer

The second reason for patients having the amputation is the treatment of bone cancer. According to American Cancer Society, one of the methods to deal with the cancer is to eliminate the limbs having cancer cells clusters when limb salvage, a surgery to cut off small parts of expremity, cannot remove all of the tumors. Amputation is still the prime process to take care the bone cancer.

Injury

The injury is the third reason why patients need amputation. According to Iran-Iraq and USA-Vietnam war reports, the most regular side-effect of post-wars is amputation, especially LEA. In 291 veterans from Iran-Iraq war, shells cause half of them to have LEA, and landmines are 34%. In USA-Vietnam war, knee amputation is usual. In other words, lower limbs amputation is the most common injury during the wars. 12981 of 20801 veterans who have the amputation is LEA; in other words, the lower limbs amputation is the majority.