Endocrine Abstracts

Introduction

The aim of our study was to search the causes of pain in diabetics followed for a lower limb amputation in physical medicine and rehabilitation (PMR) department.

Patients and methods

A retrospective study carried out between 2018 and 2020 on diabetic patients referred to PMR department for lower limb amputation.

Results

Forty-two patients were included in the study. Their mean age was 61.4 ± 15.7 years with a sex ratio of 3.2. Most patients (65%) were type 2 diabetics with a history of 15 years of diabetes, 52.4% were hypertensive and 40% had obliterating arteriopathy of the lower limbs (OALL). Infectious origin (gangrene) was the most common cause of amputation (90.5%), followed by vascular origin (4.4%). The mean delay to PMR consultation after amputation was 7.9 ± 9.5 months. Amputations involved the leg (84.4%), the thigh (13.3%) and the foot in 4.4% of cases. They were unilateral in 73.3% of cases. Re-amputation was necessary in 6 cases. Patients experienced neuropathic pain in 57.6% of cases and a sensation of non-painful phantom limb in 84.4% of cases. Neuromatous pain was noted in 6.7% of cases and overlying joint pain (in the knee or hip) was found in 17.8% of patients. Half of the patients (50.3%) received their prosthesis and 8% of them presented with a painful conflict prosthesis requiring some corrections.

Conclusion

Pain in amputees can have several aspects to consider and seek by the clinician to ensure adequate management.