{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:20:08Z","timestamp":1787746808669,"version":"build-2784847793"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82460548"],"award-info":[{"award-number":["82460548"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004479","name":"Natural Science Foundation of Jiangxi Province","doi-asserted-by":"publisher","award":["20242BAB20368"],"award-info":[{"award-number":["20242BAB20368"]}],"id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Amputation is a critical event leading to the permanent loss of limb function and long\u2010term functional impairment, posing a substantial burden on global healthcare systems. However, the global burden, demographic patterns and future trajectory of amputation\u2010related disability have not been comprehensively quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed Global Burden of Disease (GBD) 2021 data to assess the prevalence and years lived with disability (YLDs) for seven amputation subtypes (fingers, thumbs, toes, unilateral and bilateral upper and lower limbs) from 1990 to 2021. Projections to 2050 were made using the Bayesian age\u2013period\u2013cohort (BAPC) modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2021, the global total number of amputation cases reached approximately 445 million (95% uncertainty intervals [UI]: 409\u2013486 million), with an age\u2010standardized rate (ASR) of 5330 (95% UI: 4890\u20135820) cases per 100\u2009000 population. From 1990 to 2021, the overall global burden of amputation demonstrated a declining trend in ASR, although the absolute number of cases increased substantially. Among all amputation subtypes, finger amputation (AMP\u2010F) had the highest prevalence, accounting for 50.3% of all cases, followed by thumb amputation (AMP\u2010Th) at 22.4% and toe amputation (AMP\u2010Toe) at 19.0%; these three subtypes alone accounted for over 91% of all cases. Regarding YLDs, unilateral lower limb amputation (AMP\u2010LL1) contributed most significantly (20.8%), followed by bilateral upper limb amputation (AMP\u2010UL2) at 18.9%, despite their relatively lower prevalence. In terms of the YLD burden, the age distribution exhibited a spindle\u2010shaped pattern, peaking in the 30\u201359 age group overall, with notable subtype\u2010specific variations (e.g., AMP\u2010LL1 peaking at \u2265\u200995\u2009years and bilateral lower limb amputation [AMP\u2010LL2] prominent in middle\u2010aged groups, particularly 50\u201364\u2009years in certain regions). Additionally, the etiological profile shifted markedly, with conflict and terrorism rising sharply from the 8th to the 4th leading driver of amputation burden globally, exerting a particularly strong impact in North Africa and the Middle East. Projections indicate substantial future increases in both prevalence and YLDs associated with AMP\u2010LL1, necessitating heightened vigilance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although the age\u2010standardized prevalence of amputation slightly declined globally from 1990 to 2021, the absolute number of cases increased significantly, exhibiting pronounced demographic and geographic disparities. To mitigate this escalating burden, tailored strategies integrating prevention and long\u2010term rehabilitation planning are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70356","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:02:49Z","timestamp":1786089769000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Epidemiology of Amputation\u2010Related Disability From 1990 to 2021: Geographic Variation and Projections to 2050"],"prefix":"10.1002","volume":"17","author":[{"given":"Xuhui","family":"Cuan","sequence":"first","affiliation":[{"name":"Department of Orthopedics The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University  Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianguang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Affiliated 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Nanchang University  Nanchang Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengliang","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Joint and Orthopedics Zhujiang Hospital, Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine and Rehabilitation Peking University Shenzhen Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6479-9825","authenticated-orcid":false,"given":"Chao","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Joint and Orthopedics Zhujiang Hospital, Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Jin","sequence":"additional","affiliation":[{"name":"The National Key Clinical Specialty, 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