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, wards and physiotherapy department was carried out retrospectively. Amputation types, age, sex and indications were analysed. Fifty-eight amputations were performed in 5 6 patients (47 males, nine females, M: F= 5.2: 1, age range 7-70years, mean 33.3 ±S. D 18.2). Ther e were 42 lower and 16 upper limbs. Traum a accounted for 48.3 %; followed by diabetes (29. 3 %), tumours (12.1 %), infections (8.6%) and one indeterminate cause (1.7 %). There was bias for sex, age and type of extremity as trauma was the commonest indication in mal e patients aged 30years and below (and in the upper limb) whereas diabetes predominated in female patients above 30years (and in the lower limb). Infection, as an indication for amputation, has now become a rear guar d indication. Diabetes, previously uncommon, now appears in the forefront. These finding s call for early detection and aggressive management of diabetic foot lesions.