Saini Uttam Chand, Hooda Aman, Aggarwal Sameer, Dhillon Mandeep Singh
Department of Orthopaedics, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India.
J Clin Orthop Trauma. 2021 Jan;12(1):83-87. doi: 10.1016/j.jcot.2020.10.014. Epub 2020 Oct 16.
Primary amputation below the level of the knee joint is the most frequently performed amputation following trauma; however, data about incidence, patient profiling, and causative factors are seldom available in India.
To evaluate the profile and incidence of trauma-related amputations below the level of the knee joint at a level 1 trauma center.
An observational study over six months was conducted at a level 1 trauma center of north India. Epidemiological data such as age, sex, occupation, socioeconomic status, mechanism of injury, time of surgery, single or staged procedure, and complications were recorded from the admission files.
125/3047 (4.1%) trauma patients underwent amputation, of which 32.8% (41 of 125) had amputation below the level of the knee joint. Unilateral transtibial amputation was the most common (85.3%) involving 40/41 males with a mean age of 37.2 years of low socioeconomic status. Road traffic accidents were the most common cause (85.36% of cases). 39 of 41 cases presented within 24 h of injury and underwent surgery within 24 h of presentation. Secondary surgery was needed in 24.4% of the patients and revision amputation was done in only 2.4% (n = 1/41). No patient developed medical complications, and the average hospital stay was 8.7 days with a range from 2 to 14 days.
We have documented a significant amputation rate in trauma cases (4.1%) reflecting on the seriousness of patients seen at our center. Most patients are young males at the peak of their productive lives, and from low socioeconomic status. Road Safety is essential, and specialized services for the amputees may be the need of the hour.
膝关节以下的一期截肢是创伤后最常施行的截肢手术；然而，在印度，关于发病率、患者概况及致病因素的数据却鲜有可得。
评估一家一级创伤中心膝关节以下创伤相关截肢的概况及发病率。
在印度北部一家一级创伤中心开展了一项为期六个月的观察性研究。从入院档案中记录年龄、性别、职业、社会经济状况、损伤机制、手术时间、单次或分期手术以及并发症等流行病学数据。
125/3047（4.1%）例创伤患者接受了截肢手术，其中32.8%（125例中的41例）为膝关节以下截肢。单侧经胫骨截肢最为常见（85.3%），涉及40/41例男性，平均年龄37.2岁，社会经济地位较低。道路交通事故是最常见的原因（占病例的85.36%）。41例中的39例在受伤后24小时内就诊，并在就诊后24小时内接受手术。24.4%的患者需要二次手术，仅2.4%（n = 1/41）的患者进行了截肢翻修手术。无患者出现医疗并发症，平均住院时间为8.7天，范围为2至14天。
我们记录了创伤病例中显著的截肢率（4.1%），这反映了我们中心所见患者的病情严重程度。大多数患者是处于生产黄金期的年轻男性，且社会经济地位较低。道路安全至关重要，为截肢者提供专门服务可能是当务之急。
