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Surgical Limb Amputation: A Five-Year Experience At Hilltop Orthopedic Hospital Enugu, Nigeria
Abstract
BACKGROUND: Limb amputation is one of the oldest and commonest surgical procedures known to man. It is performed by the orthopedic, general, vascular and trauma surgeons. At Hilltop Orthopedic Hospital, Enugu, limb amputation is found prevalent, yet most times it is objectionable to the patient.
METHOD: A prospective study was decided and carried out on all limb amputations over a five-year period, between January 1998 and December 2002.
AIM The aim was to analyzed the indications for the amputations and the outcome to see it they really justifiable.
RESULTS: 44 amputations were done in 44 patients in the age range of 9 to 83 years with the peak age incidence in the 4th decade. Trauma was commonly found in our sub region as the commonest indication for amputation in 52% of cases. However, it was found out that mismanaged trauma constituted the greater majority of cases due to trauma making up 34%, while trauma per se made up the remainder 18%. All the cases of mismanaged trauma were by the traditional bonesetters. Ignorance was found to be the reason for this mismanagement. Ways of eliminating this ignorance are suggested. There was a mortality of 15%, which is on the high side but within the general range quoted for amputation for trauma in civilian practice. Most of the survivors, 35 out of 37 (95%) were able to lead a reasonable degree of independent life.
CONCLUSION:
Traditional bone setting is a problem area in our culture. Legislation might be necessary to stem the tide of these avoidable problems.
KEY WORDS: Amputation, Indication, traditional bone setting
Nigerian Journal of Orthopaedics and Trauma Vol.3(2) 2004: 139-149
METHOD: A prospective study was decided and carried out on all limb amputations over a five-year period, between January 1998 and December 2002.
AIM The aim was to analyzed the indications for the amputations and the outcome to see it they really justifiable.
RESULTS: 44 amputations were done in 44 patients in the age range of 9 to 83 years with the peak age incidence in the 4th decade. Trauma was commonly found in our sub region as the commonest indication for amputation in 52% of cases. However, it was found out that mismanaged trauma constituted the greater majority of cases due to trauma making up 34%, while trauma per se made up the remainder 18%. All the cases of mismanaged trauma were by the traditional bonesetters. Ignorance was found to be the reason for this mismanagement. Ways of eliminating this ignorance are suggested. There was a mortality of 15%, which is on the high side but within the general range quoted for amputation for trauma in civilian practice. Most of the survivors, 35 out of 37 (95%) were able to lead a reasonable degree of independent life.
CONCLUSION:
Traditional bone setting is a problem area in our culture. Legislation might be necessary to stem the tide of these avoidable problems.
KEY WORDS: Amputation, Indication, traditional bone setting
Nigerian Journal of Orthopaedics and Trauma Vol.3(2) 2004: 139-149
