The Epidemiology of Paediatric Upper Limb Amputations in Malaysia (2011-2024): A Single-Centre Analysis and Comparative Review

Objective : Traumatic upper limb amputations in the paediatric population, while relatively rare, are associated with significant and long-lasting physical and psychological morbidity. Data from a single-centre retrospective cohort study of 83 patients in Malaysia from 2011 to 2024 were analysed to provide a descriptive epidemiological profile of these injuries. The study’s objectives were to characterize the demographic distribution, identify common injury mechanisms and patterns, and evaluate management strategies and their outcomes. The findings were compared with published regional and global literature to identify trends and unique local characteristics. Methods: The data for this study were obtained from a retrospective cohort of 83 patients who received treatment for paediatric upper limb traumatic amputation or near-amputation at a single Malaysian hospital between 2011 and 2024. The patient age range was from 0 to 18 years. Medical records were analysed for demographic data, injury characteristics and management trends. Results: There is a significant male predominance (84.3%) observed. Crush injuries were the leading cause (57.8%), with doors and bicycle chains being the most common culprits. The most frequent injury was a near-total amputation (59%), primarily affecting the distal phalanx (44.6%) of the ring and index fingers. While microsurgery was used in a minority of cases (15.7%), the majority of outcomes were favourable. The findings are compared with international data, revealing both similarities in demographics and differences in aetiology, highlighting the need for culturally and contextually specific injury prevention strategies. Conclusion: The data from this Malaysian cohort is largely consistent with epidemiological patterns reported in other Asian countries and globally, highlighting the importance of targeted public health interventions to address specific, age-related hazards and to enhance the capabilities of specialized care centres.