Amputation of the limbs: 10 years’ experience at Enugu State University Teaching Hospital

Abstract

Background: Limb amputation is a veritable means of saving lives in the West African sub-region where patients present late to hospitals with severe injuries; often in the presence of previously undiagnosed co-morbidities. In this region, many amputees are left permanently without prosthetic fittings for variable reasons, and without adequate occupational rehabilitation this impacts on the life of the amputee; especially in the productive age group.
Objective: Aim of this study is to determine the pattern of limb amputations, identify the common indications, incidence, problems and complications of the procedure at ESUTH, Enugu.
Methodology: A 10-year retrospective study of all amputations done in the hospital (January 2003 to December 2012) was carried out. Data collected from the case notes and operation registers included demography, indication for amputation, levels of amputation, affected limb, prosthetic fitting and complications.
Results: There were 94 amputations involving 86 patients. The most common indication for amputation was gangrene from diabetes mellitus. Male to female ratio was 1.2 to 1; age range was 5 to 88years with mean age 45.4years. Peak age incidence was in the 6th decade. Below knee amputation was the most common operation, and delayed wound healing, the commonest postoperative complication. Thirty amputees procured prosthesis within three months of discharge from hospital.
Conclusion: Diabetic foot gangrene is the commonest indication for limb amputation in our series. The incidence is higher among elderly people. Compliance with prosthetic fitting among amputees is very low.

Keywords: Compliance, complications, indications, pattern, prosthetic fitting, rehabilitation