Complications of major lower limb amputations before prosthetic provision at a tertiary care rehabilitation facility

Abstract

Background: Although postoperative complications of lower limb amputations and complications related to prosthetics are well known, complications before prosthetic fitting are less often emphasized in literature. There are no Saudi studies documenting the complications before prosthetic fitting where there is high rise in dysvascular amputation, and early prosthetic provision remains a challenge. Objectives: To investigate the complications following major lower limb amputations (MLLAs). Study design: Retrospective study. Methods: One hundred thirty-six electronic files for individuals with major lower limb amputations were reviewed. Individuals visiting the primary limb loss clinic for the first time, who have not been fitted with a prosthesis before, were included. Results: Muscle weakness was the most common complication (55.1%), followed by edema (52.9%), while infection was found to be the least frequent (5.1%). Age was significantly associated with etiology (p value < 0.001), usage of assistive device (p value = 0.002), and complications (p value = 0.013). Complications were also significantly associated with time since amputation (p value = 0.001). In addition, etiology was significantly associated with the usage of assistive device (p value = 0.012). Conclusions: Muscle weakness and edema were the most common complications after MLLA in a cohort of patients with median onset of 8.5 ± 6.8 months since amputation. Presence of various complications in MLLAs before prosthetic evaluation reflect gaps of care including delayed prosthetic evaluation. National strategies need to be introduced to promote early rehabilitation interventions, prevent complications, and improve quality of life of individuals with MLLAs.