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Minor injury resulting in lower-limb loss in diabetic patients

Department for orthopaedic rehabilitation Tel Aviv University

Zeev Sussak

Fleischman Unit for the Study of Disabilities, Loewenstein Rehabilitation Centre, Raanana Sackler School of Medicine, Tel Aviv University, Israel

Reuben Eldar

Fleischman Unit for the Study of Disabilities, Loewenstein Rehabilitation Centre, Raanana Sackler School of Medicine, Tel Aviv University, Israel

Objective: to identify diabetic patients who had undergone recent amputation of the lower limb, and in whom a possibly avoidable minor injury to the foot had caused infection and gangrene necessitating surgical intervention.

Design: questionnaires, administered to consecutively admitted recent lower-limb amputees, addressing demographic, socio-economic and medical data and containing specific questions on circumstances or events that might have caused a foot lesion that started the infection, gangrene and eventually amputation.

Setting: department of orthopaedic rehabilitation in a rehabilitation hospital.

Patients: 218 recent, lower-limb amputees - due to occlusive arterial disease, with or without diabetes - admitted for prosthetic rehabilitation during 30 months (January 1989 to June 1991).

Results: 56 diabetic and 10 non-diabetic amputees were identified in whom a minor injury had caused the sequence leading to amputation which could have been avoided by adequate attention to the feet and their care.

Conclusions: All diabetic individuals need education regarding self-care and attention to the feet, irrespective of their demographic or socio-economic variables and disease severity. The view is expressed that such an education — particularly when linked to the provision of necessary health services - would be able to reduce the risk of amputation in diabetes mellitus considerably.

Clinical Rehabilitation, Vol. 6, No. 2, 97-101 (1992)
DOI: 10.1177/026921559200600202


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