Epidemiology and Indications for major limb amputations in Ilorin, Nigeria

Abstract

Limb amputation refers to the removal of a limb or part of a limb through the bone. It is one of the oldest surgical procedures known to man. In the western world, dysvascular amputations (secondary to complications from diabetes mellitus and peripheral vascular disease) account for most of the amputations done. Traditionally, trauma and complications from badly managed traumatic injuries continue to account for most of the major limb amputations in Nigeria. We sought to evaluate the indications and patient characteristics amongst patients who had major limb amputations over a four-year period at a University Teaching Hospital in North-Central Nigeria.  Eighty-seven patients had major limb amputations in the period under review. The majority (63%) of the amputees were male and 78% of the amputees had lower limb amputations. Dysvascular amputations (45.8%) and complications of trauma (43.4%) accounted for similar proportions of the causes of amputations in the study. Two peak age groups were involved: the third decade of life where traumatic causes predominated; and the seventh decade of life where dysvascular causes predominated. Public health interventions need to be intensified to improve management of traumatic injuries to reduce the rate of amputations in this cohort while improved education and management of diabetic patients will reduce the rate of dysvascular amputations.