Amputations in eastern Turkey (Van): a multicenter epidemiological study

Objectives: The indications for amputations vary among countries and different regions depending on many factors. This study was designed to evaluate amputations performed in the province of Van and to determine specific causes of amputations associated with geographical and cultural characteristics of the region. Methods: A total of 475 amputations were performed in 440 patients (345 males, 95 females; mean age 28.5 years; range 3 months to 85 years) in medical institutions of Van between 1995 and 2005. The patients were evaluated with respect to age and sex, etiology, side and level of amputa¬tions, and surgical interventions performed. Results: Amputations were the most common in the 21 to 30- year age group with 109 patients. Pediatric patients below the age of 10 years accounted for 13.4%. Of all the amputations, 218 (45.9%) involved the upper extremity, and 257 (54.1%) involved the lower extremity. Amputations were right-sided in 223, left-sided in 188 patients, and 29 patients underwent multiple amputations. Trauma was the most common cause of amputations (n=177, 40.2%), with leading etiologies as gun¬shot injuries (n=45), land mine (n=33) and hand grenade (n=7) blasts. Other frequent indications apart from traumatic causes were diabetes mellitus (n=86), congenital diseases (n=33), and peripheral vascular disease (n=30). Causes more specific to regional characteristics were tandoor burns (n=7), mistreat¬ment by traditional bonesetters (n=3), and frostbites (n=3). Re¬plantation was performed in 24 patients, of which 15 (62.5%) were successful. Conclusion: Our region features gunshot injuries and land mine blasts as the most common traumatic causes of am¬putations.