Investigation into a Predominant Laterality for the Development of Lower-Extremity Neuropathic Ulceration and Amputation.

Abstract

Background: The incidence of neuropathic pedal ulceration is on the rise, especially as rates of type 2 diabetes continue to increase. Currently, there is limited research into the laterality for the development of lower-extremity neuropathic ulceration or a predominant side for amputation. However, identifying whether a predominant laterality exists could allow for better preventive measures to help mitigate risk and decrease the significant quality of life and health-care costs associated with lower-extremity ulceration and amputation. We sought to determine whether a predominant laterality exists for the development of lower-extremity neuropathic ulceration and amputation.

Methods: Patient data from the authors' primary health-care facility were retrospectively reviewed to determine the laterality of the initial presenting lower-extremity neuropathic ulcerations as well as the laterality of the initial lower-extremity amputations experienced during their care, if any.

Results: A total of 136 patients were included in the study, with 61% of the initial ulcerations presenting on the right and 39% on the left, which was statistically significant. Of the 70 patients who went on to require amputation during their care, 67% experienced right-sided amputation and 33% experienced left-sided amputation, which was also statistically significant.

Conclusions: The right lower extremity likely shows a predominance for the development of neuropathic ulceration and likewise is at a higher risk for advancing to lower-extremity amputation.