Outcome after trans-tibial amputation for vascular disease. A follow-up after eight years.
All 112 patients (55 females and 57 males) with a primary unilateral trans-tibial amputation for vascular disease performed in one year at all five hospitals in Malmöhus county, Sweden were examined at 6 months according to the prosthetic function and prospectively followed-up 8 years after the amputation for survival, and prosthetic fitting. The prosthetic function was re-examined among the survivors 8 years postoperatively. At 6 months 50% were fitted with a prosthesis and later (up to 8 years) a further 13%, in total 32 females and 39 males. The mortality at 6 months was 33%, at 2 years 47% and at 8 years 92%. Age at amputation (p = 0.015), to be amputated on the left leg (p = 0.0004), to be able to walk alone outdoors before the amputation (p = 0.007) and not using a wheelchair (p = 0.02) were all found to be statistically significant predictors for receiving a prosthesis. Predictors for good function with the prosthesis 6 months postoperatively was male sex (23 of 57 vs 8 of 55 females) (p = 0.006) and greater ability to walk alone outdoors before the amputation (p = 0.01). There was no significant age difference in this comparison. The finding that it is more favourable to be amputated on the left leg merits further study.
Hermodsson
Y
Y
Department of Orthopaedics, Helsingborg Hospital, Sweden. ylva.hermodsson@nvs.ltskane.se
Ekdahl
C
C
Persson
B M
BM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects / Q000401:mortality / Q000534:rehabilitation*; D001186:Artificial Limbs; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D012307:Risk Factors; D016019:Survival Analysis; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome