Prevalence and pattern of traumatic limb amputations in female population of Bhimber District, Azad Jammu and Kashmir, Pakistan

Traumatic limb amputations [TLA] are structural defects that cause mild-to-severe disabilities and have significant impact on the quality of life of subjects. A recent epidemiological study in Bhimber District, AJK, Pakistan, revealed that TLA had a very high incidence among the young/adult females. The present study aimed at determining the prevalence, pattern, causes and risk factors associated with TLA in that female sample. In a prospective door-to-door survey, 1731 females were randomly enrolled, and clinico-etiological investigations on 19 subjects with TLA were carried out in a follow-up study. Affected subjects were physically examined and phenotypic detail and restriction to normal function were documented. There were 19 subjects with TLA, hence the prevalence was estimated to be 10.98/1,000 [0.011%; CI=0.0061-0.0159]. TLA mostly involved the upper limbs and right hand. Transphalangeal amputations were most frequent, followed by involvements of middle/upper arm and leg segments. These analyses further revealed that agriculture tools were the leading cause of trauma. TLA were witnessed to be higher in subjects originating from Samahni tehsil [OR:2.71], rural areas [OR:3.33], those who were illiterate [OR:2.65], married, spoke Pahari language [OR:1.73], those who fall in higher age category [OR:16.74], and had certain professions. Limb amputations had heavy bearings on the lives of subjects. Curiously, majority of these traumas could be avoided by adopting certain safety measures. Prevalence and risk estimate of TLA across various socio-demographic variables of Bhimber population would be useful in guiding further studies and the public health policy to mitigate the impact of these anomalies

Zygodactyly with thumb aplasia: an unusual variant in a male subject

This is a presentation of a male subject with unusual combination of limb malformations. The subject had unilateral zygodactyly of the left foot with thumb aplasia in the right hand. Further, the webbing between second and third toes was complete culminating in osseous fusion of the terminal phalanges and valgus deviation of the affected digits of the foot. The nails were also involved but had separate origins. In the right hand, first digital ray was observed to be completely omitted. There was aplasia of certain carpals while the radius showed minimal clinical symptoms. The subject was the product of first cousins union. To the best of our knowledge, this combination of limb phenotype has not been described before