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Limb amputations in Abakaliki, South East Nigeria

Background: Limb amputation is a preventable and important public health concern in developing countries. We aimed at determining the pattern, indications, and outcome of limb amputations in our environment. Materials and Methods: A hospital-based retrospective review of the database of all limb amputations in Federal Teaching Hospital in Abakaliki, Ebonyi State, Nigeria from January 2002 to December 2012. Results: In 184 patients, there were 192 limb amputations; 141 (73.9%) of the amputations were major and 51 (26.1%) were minor. The male-to-female ratio was 3.5:1 and the mean age was 33.8 ± 1.95 years. The common indications for amputation were trauma (69.0%), diabetic foot gangrene (16.3%), and malignancy (7.1%). Lower limb was significantly more involved than the upper limb in all indications of amputation (P < 0.001). Wound infection (40.2%), severe anemia (11.4%), and wound dehiscence 9.2% were the three top complications observed. The mean and median lengths of hospital stay were 43.3 ± 3.1 and 36 days, respectively. The mortality rate was 8.7%; it was significantly higher in females than males (17.1% vs 6.3% P < 0.031) and in nontrauma-related amputations than trauma-related ones (15.8% vs 5.5% P < 0.022). The rate of successful prosthetic rehabilitation was 18.5%. Conclusion: In our environment, trauma and diabetic foot gangrene are common causes of limb amputation. The observed pattern of predominantly major amputations and the relatively high morbidity associated with amputation in our environment call for appropriate policy response aimed at prevention and optimum care.