Amputation of the Lower Extremity in Diabetes Mellitus: A Follow-Up Study of 294 Cases

Silbert, Samuel

doi:10.2337/diab.1.4.297

Cited by 42 publications

(9 citation statements)

References 0 publications

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“…In a series of unilateral diabetic amputees Baddeley & Fulford (1%5) recorded 20% contralateral amputations within three years. The corresponding findings of Silbert (1952) were 30% after three years and 51% after five years. Mazet (1967) in a group of unilateral diabetic amputees computed the risk of contralateral amputation at 10,20 and 40% after 1, 2 and 5 years.…”

Section: Discussionmentioning

confidence: 80%

“…Over the years many studies have attempted to clarify the fate of the arteriosclerotic and diabetic amputee, with respect to later ipsi-or contralateral amputation (Silbert 1952;Goldner 1960;Baddeley & Fulford 1%5;Mazet 1%7;Sarmiento 1968;Whitehouse et al 1968;Persson & SundCn 1971;Kolind-Sdrensen 1974); and also mortality Smith 1956;Hansson 1964;Whitehouse et al 1968;Ecker & Jacobs 1970;Persson & SundCn 1971;Kahn 1974;Kolind-Sgkensen 1974).…”

Section: Introductionmentioning

confidence: 99%

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Incidence of reamputation and death after gangrene of the lower extremity

Ebskov

Josephsen

1980

Prosthetics &Amp; Orthotics International

122

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Since 1972 the Danish Amputation Register (DAR) has recorded major amputations in Denmark. The register is based on voluntary detailed reports from surgical and orthopaedic departments. The present investigation is based upon 2029 amputations for arteriosclerotic and diabetic gangrene with an observation period up to 4 years. The incidence of ipsilateral reamputation is high in the immediate postoperative period with 10-4% after one month, 16-5% after three months and 18-8% after six months. Later the incidence is quite low, reaching a total of 23-1% after four years. The risk of contralateral amputation is ever present with an incidence of 11-9% within one year, 17-8% after two years, 27-2% after three years, and finally 44-3% after four years. The mortality after three months is 16-3% and then tapers off to a total of 22-5% after four years. As compared with the normal population a significant over-mortality is seen during the first three months, and an equally significant under-mortality from six months onward during the observation period.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Incidence of reamputation and death after gangrene of the lower extremity

Ebskov

Josephsen

1980

Prosthetics &Amp; Orthotics International

122

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“…This difference in survival between the two groups of amputees was significant (p<0.006) and is similar to the reports by Smith (1956), (diabetic patients only), but less than those reported by Kolind-S~rensen (1974) and Whitehouse et al, (1968). Silbert (1952) reported a 61% survival at 3 years and 41% at 5 years in a study of 294 diabetic amputees. Ebskov and Josephsen (1980) reported 22.5% survival at 4 years for 2,029 patients which is much less than this group, Pohjolainen and Alaranta (1988) reported 27% mortality at 3 YOW8 Graph 4.…”

Section: Discussionmentioning

confidence: 98%

Lower limb amputee survival

Stewart¹,

Jain²,

Ogston

1992

Prosthetics &Amp; Orthotics International

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A total of 1710 primary amputees have been studied over a 25 year period and their survival time has been calculated. These were all consecutive primary lower limb amputees admitted to the Dundee Limb Fitting Centre during the period 1965–1989. Overall, the median survival was 4 yr 9 mth for the below-knee amputee (1019 patients) and 4 yr 3 mth for the above-knee amputee (586 patients). The vascular related amputees had an overall median survival of 4 yr. In the two decades 1970–1979 and 1980–1989 there were significant differences between the survival time of the below-knee and above-knee amputee. The survival of the amputee has increased during the two decades from 3 yr 6 mth to 6 yr 6 mth (p>0.001). For the first decade male above-knee and male below-knee amputee median survival was 3 yr 1 mth and 3 yr 11 mth respectively and for the second the survival was 5 yr 9 mth and 6 yr 11 mth for these levels of amputation. For 1970–1979 no significant differences were found between male and female peripheral vascular disease (PVD) and diabetes mellitus related amputee survival. For 1980–1989 significant differences were found between PVD related male above-knee amputees (3 yr 10 mth) and male below-knee amputees (6 yr 7 mth) (p>0.01). Similar results were found for the female patients. Operative mortality was found to be 5% over the period 1975–1989 which compared favourably with previous studies.

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“…Moreover, the long-term outcome must be considered. Within 3 years following major amputation, diabetic patients have a mortality rate of 30-50 percent and a similar rate of second leg major amputation (Silbert 1952, Goldner 1960, Hoar and Torres 1962, Cameron et al 1964, Ecker and Jacobs 1970, Palumbo and Melton 1985, Jernberger 1989, Levin et al 1993). In the long-term perspective, minor amputations are associated with a lower risk than major amputations with regard to a new major amputation and have a considerably better rehabilitation potential (Larsson 1994).…”

Section: Minor Versus Major Amputationmentioning

confidence: 99%