Predictive factors for prosthetic fitting after Diabetic foot amputation at a tertiary hospital: a retrospective review.

Abstract

ABSTRACT Background: Amputations are frequently performed as a life-saving procedure in underdeveloped nations due to trauma, infection, uncontrolled diabetes mellitus, and malignancy. Diabetes is a major contributing factor to lower limb amputation. Prosthetic rehabilitation plays a crucial role in restoring functional mobility for diabetic foot amputees, allowing them to regain independence and actively engage in their communities. Lack of access to prosthetic rehabilitation in low- and middle income countries causes significant physical, financial, social and emotional effects from limb loss, which affect their overall quality of life. Aim: To determine factors that predict prosthetic fitting of diabetic foot amputees at Muhimbili National Hospital Complex. Methodology: This was a retrospective cross-sectional study among diabetic lower limb amputees at Muhimbili. Patients were included if they had transtibial or transfemoral amputation, healed stump, are available to participate and provide consent to be interviewed. Variables collected included demography, clinical features, and type of amputation were collected using a predefined data abstraction sheet on RedCap platform, Analysis was conducted using SPSS software version 27 to establish prosthesis fitting rate and factors associated with it among diabetic amputees. A significant association was considered when P-value was <P < 0.05. Results: A total of 146 diabetic foot amputees met the study criteria and were included with a Median age of 61 years with IQR 28.9, majority of which were ≥55 years at 81(55.50%) of study participants. Most of the patients were male at 88(60.03%). Only 17(11.6%) of the patients had a foot prosthesis fitted with age <55, female sex, education of prosthesis, attending physiotherapy, and referral to prosthesis being significant predictors. Conclusion: Prosthetic rehabilitation rates are low among diabetic limb amputees at Muhimbili. There are low referral rates for prosthetic fitting among limb amputees at this facility and this needs to be addressed. Only 50% of referred patients Key terms: Rehabilitation, Prosthetic fitting, Amputation of limb, Limb loss surgery.