title: Incidence and causes of lower-limb amputations in the city of Ribeirão Preto from 1985 to 2008: evaluation of the medical records from 3,274 cases.
abstract: OBJECTIVE
  It was to identify trends of traumatic and non-traumatic causes of lower limb amputations, as well as the role played by population aging, traffic violence increase, public health policy of diabetes control program and drivers anti-alcohol laws on these amputations.
  
  
  METHODS
  Hospitalization data recorded in the discharge forms of 32 hospitals located in the region of Ribeirão Preto, Brazil, from 1985 to 2008 were analyzed.
  
  
  RESULTS
  A total of 3,274 lower-limb amputations were analyzed, of which 95.2% were related to non-traumatic causes, mainly infectious and ischemic complications of diabetes mellitus. Cancer (2.8%) and congenital (1.3%) causes were included in this group. Only 4.8% were related to traumatic causes. Traumatic amputation average rate was 1.5 amputations in 100,000 habitants with a slight tendency of increase in the last 5 years. Non-traumatic causes showed an average rate of 30.0 amputations for 100,000 habitants and remained relatively constant during the whole period. Non-traumatic were much more predominant in patients older than 60 years and traumatic amputations occurred more frequently in patients younger than 39 years.
  
  
  CONCLUSIONS
  The overall rates of amputation and the rates of traumatic and non-traumatic amputations remained nearly constant during the study period. The impact of diabetes control policies and the introduction of traffic safety laws could not be identified on the amputation rates.
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil.
authors.forename: Bruna Maria Bueno
authors.initials: BM
authors.lastname: Barbosa
authors.affiliation: Department of Social Medicine, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil.
authors.forename: Rosane Aparecida
authors.initials: RA
authors.lastname: Monteiro
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil.
authors.forename: Lucas Françolin
authors.initials: LF
authors.lastname: Sparano
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil.
authors.forename: Rodolfo Fabiano Niz
authors.initials: RF
authors.lastname: Bareiro
authors.affiliation: Department of Social Medicine, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil.
authors.forename: Afonso Dinis Costa
authors.initials: AD
authors.lastname: Passos
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil.
authors.forename: Edgard Eduard
authors.initials: EE
authors.lastname: Engel
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D001938:Brazil; D002648:Child; D048909:Diabetes Complications / Q000601:surgery; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D007869:Leg Injuries / Q000601:surgery; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D013997:Time Factors; D014504:Urban Health; D055815:Young Adult