Prevalence and pattern of major extremity amputation in a tertiary Hospital in Nnewi, South East Nigeria

Introduction: Amputation surgery is an orthopedic surgical procedure carried out as the last resort, when limb salvage is not feasible. It is usually associated with social, emotional and psychological disturbances to the patient and the family. Objectives: To determine the prevalence and pattern of amputation surgeries in the Orthopedic unit of the Nnamdi Azikiwe University teaching hospital (NAUTH) Nnewi. This will be compared with trends in similar studies. Patients and Methods: This was a 2 year retrospective analysis of major limb amputations in NAUTH Nnewi from January 2011 to December 2012. Information extracted from the case notes included the biodata, indication for amputation, levels of amputation, complications and prosthetic use. Result: A total of 90 patients had major extremity amputations. All the cases were unilateral amputations. The age range was 17 to 89 years with a mean of 58.3 ± 15.9 years. The male to female ratio was 1.5:1. The amputation prevalence amongst all orthopedic surgeries within the period was 21.8%. Diabetic foot gangrene was the most common indication for amputation in 65 (72.2%) patients. Below knee amputation was the most common level of amputation (64.4%). Wound dehiscence was the most common complication. Only 10 patients used prosthesis and the mortality rate was 34.1%. Conclusion: There is a high prevalence of limb amputation in this study with diabetic gangrene being a leading cause. The public should be enlightened to adopt a better health-seeking attitude which may help to drastically control the almost epidemic menace of diabetes and the complications.