Lower limb amputation in Jos, Nigeria

Abstract

Objective: To determine the pattern of lower limb amputation (LLA) and highlight preventable causes in our hospital. Design: A retrospective study. Setting: University Teaching Hospital, Jos, Nigeria. Subjects: Eighty seven patients who had LLA over a five and a half year period. There were 62 males and 25 females aged between three and 83 years (mean±SD = 44.5 ± 21.1). Main outcome measures: Indications, morbidity and mortality. Results: A total of 94 LLA were performed in the 87 patients managed. Trauma, diabetic foot sepsis and malignant conditions of the limb were the main indications for LLA in 26(29.9%), 23(26.4%) and 20(23%) patients respectively. Others were peripheral vascular gangrene (PVG) in eight (9.2%) patients; chronic osteomyelitis, three (3.5%); chronic leg ulcers, three (3.5%); Ainhum, three (3.5%) and snake bite in one patient (1.1%). Above knee amputation (AKA) was the most common procedure performed (48.9%) followed by below knee amputation (BKA) in 37.2%. There were 11 deaths (12.6%), out of which eight were due to sepsis with multiple organ failure following diabetic foot sepsis, two cases of clostridial myonecrosis complicating compound fractures and a case of metastatic osteosarcoma in a child. Conclusion: Majority of the cases of LLA could have been avoided with early presentation and appropriate management. A case is made for community health education on the need for early presentation to hospital for limb lesions.