Contemporary Patterns of Limb Amputation in South Asia: A Systematic Review

Limb amputation remains a major cause of disability worldwide and is associated with substantial physical, psychological, and socioeconomic consequences. This systematic review evaluated the epidemiology of limb amputation across South Asia. A comprehensive search of PubMed, Google Scholar, and Scopus identified studies reporting demographic characteristics, etiology, or amputation patterns from India, Pakistan, Bangladesh, Nepal, and Sri Lanka. Data were extracted on study characteristics, participant demographics, etiology, and level of amputation and were synthesized descriptively because of heterogeneity among studies. A total of 26 studies comprising 14,169 participants met the inclusion criteria. India contributed the largest number of studies, followed by Pakistan, while only limited data were available from Bangladesh, Nepal, and Sri Lanka. Trauma was the predominant cause of limb amputation in India, Pakistan, Bangladesh, and Nepal, accounting for approximately 60%–75% of reported cases, whereas nontraumatic causes predominated in Sri Lanka. Males represented the majority of amputees across all countries, and lower-limb amputations were substantially more common than upper-limb amputations. Considerable heterogeneity was observed in study methodology and reporting practices. Overall, trauma remains the leading cause of limb amputation across most South Asian countries, although important inter-country differences exist. The available literature is heavily concentrated in India and Pakistan, highlighting significant evidence gaps in other South Asian nations. Strengthening injury prevention strategies, rehabilitation services, and epidemiological surveillance systems may help reduce the burden of limb loss across the region.