TY - JOUR ID - TI - Non-Traumatic Lower Extremity Amputation (The Common Causes)………………………………………. AU - Dr. Mahdi A. Abdul Hussein PY - 2009 VL - 2 no.6, 7 IS - 4 SP - 479 EP - 485 JO - Karbala Journal of Medicine مجلة كربلاء الطبية SN - 19905483 29580889 AB - objective:Lower Extremity Amputation (LEA): is defined as the complete loss in the transverseplane of any part of the lower limb, and categorized as(1): (1) Minor (i.e. at or below theankle joint). (2) Major (i.e. above the ankle joint).Method & patients:The aim of this study is to determine the common causes of non-traumaticL.E.A. It is a retrospective study of (138) patients, with 149 lower limbs treated by amputationfor different causes in Al-Hussein general and Al-Abass private hospitals in Karbala, in theperiod between Sep, 2002 through Sep, 2007, excluding cases due to trauma, military and armyattacks.Results: Diabetes is a major risk factor for LEA and form (78.5 %) of cases with differentpresentations. The important risk factors were infected deep ulcer in neuropathic foot (26 cases),late stages of infected foot (38 cases) and arteriosclerosis (51 cases) presented as gangrene in onetoe or more. Patients with loss of protective sensation, loss of education and preventive programand neglect the ulcer or mild injury to complicate and presented in late stages end withamputation. Non-diabetic peripheral vascular disease (17%) is the 2nd cause; it is eitherarteriosclerosis or Beurger disease. Other rare causes were primary malignant bone tumor (3%)and other miscellaneous causes such as non-diabetic chronic osteomylitis (1.5%). Minoramputations were 61 limbs (i.e.41%) but major amputations were 88limbs (59 %). (19) Patientsfrom diabetic group had history of previous major amputations in the same side or other limb,and (11) of them done during the study period, so considered as risk factor.Conclusion:Diabetic foot is the most common cause of LEA, and reduction in the number ofamputation can be achieved if the patient is directed to foot-care programs. The diabetics needcomprehensive care, included good endocrine control, education on endocrine control, yearlyfoot screening by multidisciplinary foot-care team. The patients should instructed to paymeticulous attention to foot wear, foot hygiene, to cutting nail and daily foot inspection toreducing the risk of an injury that can lead to heel ulcer and amputation.

ER -