Indications and early post-operative complications of major limb amputations in University of Ilorin Teaching Hospital, Ilorin

Abstract

Major limb amputation (MLA) is an amputation at or proximal to the wrist or ankle and has been practiced for centuries for a variety of reasons which change with community dynamics over time. In the last 2 decades, no study has been carried out on the current indications and early post-operative complications profile in this centre hence the reason for this study.

Consenting patients with indications for MLAs were recruited and prepared for amputation following standard operating procedure. A standard protocol for post-operative management was carried out tailored to each patient’s need. Discharge was considered when patient was fit.

Fifty-three patients were recruited with a male:female ratio of 2.8:1. The mean age was 42+/-19.8yrs while the peak age range was 21 – 30yrs (32.1%). Majority (28%) were traders and trauma (34%) was the leading indication for amputation followed by diabetic foot gangrene (22.6%). Road traffic accidents accounted for 66.6% of all trauma cases while the mean waiting period before surgery was 7days. Amputations were commoner on the right side of the body (52.8%), in the lower limbs (84.9%) and below knee amputation was the commonest (58.7%). The early post-operative complication rate was 66%, the commonest complication was wound infection while the mortality rate was 5.7%. No patient (0%) was fitted with prosthesis prior to discharge or during follow up.

Trauma remains the commonest indication for amputation in this centre and is predominant among young active males. Diabetic foot gangrene follows closely as the commonest non-traumatic cause.

Keywords: Major limb amputation, Indications for Amputation, Early post-operative complications, Ilorin