The scope of amputations in a Nigerian teaching hospital

Abstract

In developing countries, amputations have been performed due to trauma and infections; whereas in developed counties, trauma, diabetes and peripheral vascular diseases are the usual indications. Current practice in Nigeria suggests a change of relative indications, hence , this study. A five-year (July 1994 to June 1999) review of amputation records from the medical records, operating theatre , ward s and physiotherapy department was carried out retrospectively. Amputation types, age, sex and indications were analysed. Fifty-eight amputation s were performed in 5 6 patients ( 4 7 males, nine females, M: F= 5.2: 1, age range 7-7 0 years, mean 33.3 ±S. D 18.2). There were 42 lower and 16 upper limbs. Trauma accounted for 48.3 %; followed by diabete s (29. 3 % ), tumours (12.1 %), infections (8.6 % ) and o n e indeterminate cause (1.7 %). There was bias for sex, a g e and type of extremity as trauma w a s the commonest indication in mal e patients aged 3 0 years and below (and in the upper iimb) whereas diabetes predominated in female patients above 30 years (and in the lower limb). Infection, as an indication for amputation , ha s n o w become a rear guard indication. Diabetes, previously uncommon, now appears in the forefront. These findings call for early detection a n d aggressive management of diabetic foot lesions.