Pattern of presentation and indications for amputation in national Orthopaedic Hospital, Enugu

Abstract

Background: Globally, an increase in the rate of amputation is noted and it could be attributed to the sudden surge in the incidence of non-communicable diseases especially diabetes and peripheral vascular disease which is a complication of hypertension. There has been some variation in the pattern of presentation in different climes and locality depending on the availability of expertise and the infrastructures available for limb salvage procedures.

Objective: To determine the indications, demographic pattern and clinical presentation of patients that had amputation in National Orthopaedic Hospital Enugu (NOHE).

Methodology: All patients who had amputation in NOHE from 1 of September 2015 to 31 of August 2017 were recruited prospectively. The indications for amputation, demographic data and pattern of presentation of the patients were analysed with SPSS version 20.

Results: A total of 137 patients were recruited concurrently. Male to female ratio was 1.6:1. Dual peak age range of 61-70 years (22.6%) and 21-30years (20.4%) were observed. There was relative preponderance of traders (27.7%) with secondary school education (39.4%) and left lower limb was mostly involved 52.6%. Commonest mode of presentation is darkish discolouration of the foot (45.9%), with duration of symptoms most commonly between 1 - 6 months (40.9%) and 39.4% had no prior treatment before presentation. Diabetes foot gangrene (in 39%) followed by trauma (24.1%) were the leading cause of amputation from our study and above knee amputation was more commonly done (44%).

Conclusion: There is dual peaks in age groups with male preponderance in the amputations done. It commonly involved left lower limb in traders with secondary education and the commonest indication being Diabetic Foot Gangrene. Public enlightenment on diabetes is important to reduce the incidence of amputation.

Keywords: Amputation, indication, Pattern, Diabetes