Lower limb amputation in Jos, Nigeria

East Afr Med J. 2004 Aug;81(8):427-9. doi: 10.4314/eamj.v81i8.9205.

Abstract

Objective: To determine the pattern of lower limb amputation (LLA) and highlight preventable causes in our hospital.

Design: A retrospective study.

Setting: University Teaching Hospital, Jos, Nigeria.

Subjects: Eighty seven patients who had LLA over a five and a half year period. There were 62 males and 25 females aged between three and 83 years (mean+/-SD = 44.5+/-21.1).

Main outcome measures: Indications, morbidity and mortality.

Results: A total of 94 LLA were performed in the 87 patients managed. Trauma, diabetic foot sepsis and malignant conditions of the limb were the main indications for LLA in 26(29.9%), 23(26.4%) and 20(23%) patients respectively. Others were peripheral vascular gangrene (PVG) in eight (9.2%) patients; chronic osteomyelitis, three (3.5%); chronic leg ulcers, three (3.5%); Ainhum, three (3.5%) and snake bite in one patient (1.1%). Above knee amputation (AKA) was the most common procedure performed (48.9%) followed by below knee amputation (BKA) in 37.2%. There were 11 deaths (12.6%), out of which eight were due to sepsis with multiple organ failure following diabetic foot sepsis, two cases of clostridial myonecrosis complicating compound fractures and a case of metastatic osteosarcoma in a child.

Conclusion: Majority of the cases of LLA could have been avoided with early presentation and appropriate management. A case is made for community health education on the need for early presentation to hospital for limb lesions.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Amputation / methods
  • Amputation / mortality
  • Amputation / rehabilitation
  • Amputation / statistics & numerical data*
  • Causality
  • Child
  • Child, Preschool
  • Cost of Illness
  • Developing Countries
  • Diabetic Foot / surgery
  • Female
  • Hospitals, University
  • Humans
  • Leg / surgery*
  • Leg Injuries / surgery
  • Male
  • Middle Aged
  • Neoplasms / surgery
  • Nigeria
  • Patient Selection
  • Peripheral Vascular Diseases / surgery
  • Primary Prevention
  • Retrospective Studies
  • Sex Distribution