Medical and social expertise of patients after amputation of the lower limbs on the background of atherosclerosis

Abstract

Rationale. Up to 200 reconstructive operations on the aorta and arteries of the lower extremities are performed annually in the Kabardino-Balkar Republic for obliterating arterial diseases, the main of which is atherosclerosis. After performing reconstructive operations on the arteries of the lower extremities, 40–45% of patients developed a relapse of ischemia during the next 3–5 years due to the progression of the underlying disease, 80% of them undergo high-level amputations of the extremities. Carrying out medical and social expertise in the early stages after amputation is an important link in the rehabilitation of this contingent of patients.

Purpose. assessment of medical and social expertise and quality of life of patients who have undergone amputation of the lower extremities against the background of obliterating arterial diseases.

Materials and methods. The object of the study was 87 patients who had undergone amputation of the lower extremities, who were hospitalized in the vascular department of the Republican Clinical Hospital of Nalchik from 2015 to 2019. Results: The following results were obtained during the examination of patients at the Medical and social expertise bureau in Nalchik: The third group of disability was assigned to 14 patients; The second group of disability was assigned to 68 patients; The first group of disability was assigned to 5 patients. In this case, the objective data of the state of hemodynamics in the lower extremities were assessed. When assessing the quality of life of disabled people using the SF-36 questionnaire, the following results were obtained: after amputation of the lower limb, the indicators of physical health sharply decreased, and the indicator of social role also significantly decreases, not reaching half the value of the scale (38 points).

Conclusion. It is necessary to carry out a medical and social examination of patients after amputation of the lower limbs by the visiting commission of the Main Bureau of Medical and Social Expertise in the postoperative period in the hospital, while up to a period of 6 months (before hip prosthetics) for group 1 of disability patients , considering that these patients during this period need constant outside care. It is necessary to create, on the basis of rehabilitation centers, orthopedic workshops for the manufacture of good quality limb prostheses, and train patients in the use of prostheses by specialists of rehabilitation centers. After teaching the patient to use a prosthesis in a rehabilitation center, undergo a medical and social examination to obtain an appropriate group of disabilities.

Keywords

medical and social expertise / amputation of the lower extremities / obliteration of arteries

References

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