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Salvage of severely injured limbs in a developing country
Abstract
Background: Severe injuries of the limb are common in Nigeria as well as other developing countries. Management of such injuries usually presents serious challenges to the health care personnel, the patients and the relations. In most developing countries such as Nigeria, because of inherent factors, most of these injuries are treated by primary amputation despite that some can be salvaged. Amputation on its own is not readily accepted in Nigeria because of associated medical, social, religious and financial problems. This study highlights the need to carefully select the patients with severe limb injuries who may benefit from limb salvage rather than primary amputation.
Aim: To report three patients who presented with extensive limb injuries following trauma and had successful limb salvage.
Setting: Teme Clinic, a trauma centre in Port Harcourt, Nigeria.
Case reports: The 1st patient was a 35-year-old mother of three who presented with type IIIB open fracture of the tibia which was complicated by infection. Patient 2 was an eleven-year- old boy who presented with type IIIA open fracture of the right femur and an extensive degloving injury of the right leg. Patient 3 was a 25-year- old male with type IIIB open fracture of the tibia. All the three patients had injuries from traffic collisions and all had successful limb salvage after amputation was rejected by the patients and their families.
Conclusion: Limb salvage in Nigeria is feasible if patients are carefully selected using established criteria and sound clinical judgment. Amputation should be highly considered when the conditions for limb salvage are not adequate or the patient's life is threatened.
