Objectives: To review the indications for major lower limb amputations in adults and children in our patient
population and to compare our experience in prosthetic rehabilitation with that of other published information.
Material and Methods: We retropectively reviewed charts of patients who underwent amputation between 1997
to 2004 at the Orthopaedic Department of B& B Hospital (BBH ) , Gwarko and Hospital and Rehabilitation center
for Disabled Children ( HRDC), Banepa. There were 113 patients at BBH & 89 patients at HRDC . Major
amputation was defined as any amputation at or proximal to wrist and ankle. Results: Major lower limb
amputations constituted 73.58 %(39/53) of all major amputations at BBH and 97.77% (44/45) at HRDC.Road traffic
accident was found to be number one cause for major lower limb amputations (74.29%) in adult population. In
children postburn contracture was the leading cause for amputation (29.54 %) folowed by Congenital limb
conditions (22.72%) ,Spina bifida with trophic ulcers ( 20.45 %), Tumor (13.63%), Chronic Osteomyelitis (6.81%),
Trauma (4.54%) and Arthrogryposis (2.27%). Prosthetic fitting and rehabilitation is as yet far from satisfactory in
the adult population but all the children who had amputation at HRDC were fitted with prosthesis. Conclusion:
Main causes of major lower limb amputation in both population is largely preventable by instituting safty measures
and conducting awareness program. There is a need for an effective prosthetic fitting center for adults.