Aetiological Factors in Limb Amputation: The Changing Pattern!

Background : Limb amputation is a common ablative procedure in orthopaedic practice in Nigeria. Trauma and traditional bonesetters' gangrene have remained the leading indications for amputation in Nigeria. However, recent studies show that diabetic foot gangrene is becoming an important cause of limb amputation in Nigeria. Objectives: The aim of this study is to describe the demography, indications and problems of major limb amputation surgery in Makurdi, North-central Nigeria. Methodology : A retrospective review of all patients that had major limb amputations at the Federal Medical Centre Makurdi from March 2009 to March 2011 was undertaken. The data collected and analyzed were the demographic profile, indications for amputation, levels of amputation, traditional bonesetters' (TBS) treatment, complications and method of rehabilitation. Results: A total of sixty (60) patients had major, limb amputation. Four (4) patients with incomplete data were excluded and 56 patients were analyzed. The age range was 2-85 years with a mean age of 40.9 ±20.5 years. The male to female ratio was 3:1. Diabetic foot gangrene was the commonest cause of limb amputation in 22 (39.3%) patients. Above-knee amputation was the commonest level of amputation (48.2%). Wound infection was the commonest complication (12.5%). Only 4 patients (7.1%) used prosthesis and the mortality rate was 8.9%. Conclusion: Diabetic foot gangrene was the leading cause of amputation in this series. Above-knee amputation was the commonest level of amputation. Mortality rate was 8.9%. Education of diabetic patients on compliance to medication and foot care will help to reduce the incidence of diabetic foot gangrene. Keywords : Limb amputation, indications, diabeticgangrene.