Prevalence and pattern of traumatic limb amputations in female population of Bhimber District, Azad Jammu and Kashmir, Pakistan

Nazish Jabeen, Sajid Malik, Nazish Jabeen, Sajid Malik

Abstract

Objective: Traumatic limb amputations (TLA) are structural defects that cause mild-to-severe disabilities and have significant impact on the quality of life of subjects. A recent epidemiological study in Bhimber District, AJK, Pakistan, revealed that TLA had a very high incidence among the young/adult females. The present study aimed at determining the prevalence, pattern, causes and risk factors associated with TLA in that female sample.

Methods: In a prospective door-to-door survey, 1731 females were randomly enrolled, and clinico-etiological investigations on 19 subjects with TLA were carried out in a follow-up study. Affected subjects were physically examined and phenotypic detail and restriction to normal function were documented.

Results: There were 19 subjects with TLA, hence the prevalence was estimated to be 10.98/1,000 (0.011%; CI=0.0061-0.0159). TLA mostly involved the upper limbs and right hand. Transphalangeal amputations were most frequent, followed by involvements of middle/upper arm and leg segments. These analyses further revealed that agriculture tools were the leading cause of trauma. TLA were witnessed to be higher in subjects originating from Samahni tehsil (OR:2.71), rural areas (OR:3.33), those who were illiterate (OR:2.65), married, spoke Pahari language (OR:1.73), those who fall in higher age category (OR:16.74), and had certain professions.

Conclusion: Limb amputations had heavy bearings on the lives of subjects. Curiously, majority of these traumas could be avoided by adopting certain safety measures. Prevalence and risk estimate of TLA across various socio-demographic variables of Bhimber population would be useful in guiding further studies and the public health policy to mitigate the impact of these anomalies.

Keywords: Bhimber population; Epidemiology; Pakistani subjects; Prevalence; Traumatic limb amputations; Women health.

Figures

Fig-I
Fig-I
A,B,D. Terminal phalangeal amputations of 4th, 1st and 3rd digits in subjects# 9, 8 and 12, respectively. C. Firearm associated trauma in subject# 13 resulting in non-functional passively hanging arm which also had bluish appearance. E. Postaxial amputation of last digit in subject# 11. Post-traumatic healing and edema is visible. F. Postaxial amputation at the level of proximal phalange in subject# 10.
Fig-II
Fig-II
A. Pie chart depicting the percentage of severity grades of TLA. B. Pie chart depicting the causes of TLA.

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Source: PubMed

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