Any pattern changes in major lower limb amputations? a 10-year comparative retrospective study in a private orthopedic and trauma center in the south-east region of Nigeria

Abstract

Background: Major lower limb amputations are performed for various reasons, with many studies showing constantly changing patterns. Amputations are devastating procedures, even when they are done to save lives, and this is because of poor rehabilitation of amputees in our environment. Study Design and Setting: The records of all the patients who had major lower limb amputations in a private orthopedic and trauma center, south-east region of Nigeria from October 2005 to September 2010 (group A) and from October 2010 to September 2015 (group B) were reviewed retrospectively. Results: Traumatic gangrene from traffic accidents was the most common reason for amputation (47.1% in group A and 41.7% in group B) in both groups, followed by diabetic gangrene (17.6% in group A and 27.1% in group B). Traditional bonesetters’ gangrene was 13.7% in group A and 12.5% in group B. These were followed by mangled extremities and malignancies in decreasing order of frequency. Young male adults ranked high at 49.1% in group A and 58.4% in group B, while the more conservative below-knee amputation was 39.2% in group A and 47.9% in group B, compared to above-knee amputation of 52.9% in group A and 39.6% in group B. Conclusion: A greater majority of amputations are still being performed because of traumatic gangrene followed by diabetic gangrene, which had significantly increased comparatively. There is no overall change in the trend concerning the indications for amputation in this study despite the slight reduction in traumatic gangrene. However, the results indicate that the trend is toward being more conservative. The causes of traffic accidents are preventable, and, therefore, there is a need for continued public orientation to reduce the incidence of accidents on our roads and consequently reduce the amputation rate in our subregion.