Diabetic foot: An underestimated public health problem with its consequences

Objective: to find out the frequency of different types of amputation in diabetic foot ulcer. material and methods: the prospective study was conducted on 53 consecutive patients in orthopedic unit of hayatabad medical complex,peshawar,from july 2011 to june 2012 over a period of one year. all the patients who have diabetic foot ulcer of wagner grade four and five were included in the study. standard hip disarticulation,above knee amputation,trans- knee amputation below knee amputation and ray amputation were performed accordingly. results: there were total 53 patients in the study. male patients were 30 while female were 23. minimum age was 30 years,maximum 80 while average age was 58.26. according to wagner grading,9 patients were grade 4 and the rest were grade 5. right side was involved in 25(47.2%) patients while left side was involved in 28(52.8%) patients. amputation of big toe was done in 5(9.4%) patients,amputation of 2 toe in 2(3.8%) patients,amputation of 3 toe in 1(1.9%) patient,amputation of little toe in1(1.9%) patient,below knee amputation in 33(62.3%) patients,trans knee amputation in1 (1.9%) patient,above knee amputation in 9 (17%) patients and hip disarticulation was done in in1 (1.9%) patient. conclusion: the end results of prospective research on diabetic foot ulcers indicate that outcome is related to poor glycemic control and longer diabetes duration. nontraumatic lower extremity diabetic ulcers and amputations are an important and costly problem to patients,health care systems,and the government.