Current Trends in Indications and Epidermiological Characteristics of Amputations in Nigeria

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Background: Recently, we have witnessed a surge in the population of Diabetics and of course in the cases of Diabetic Foot Syndrome(DFS) requiring amputation. However, accepting amputation is difficult for patients and this has become a family or community decision to undergo amputation despite being a lifesaving procedure in most cases. Some patients have preferred to die with their gangrenous limbs in the face of ascending severe foot infection and septicemia rather than have an amputation. Aim: This study seeks to identify the current indications for amputation and its epidemiological characteristics in our hospital and by extension, our local community. Perhaps, this can be extrapolated and communicated as a Public Health warning and strategy to control the incidence, prevalence, and devastating effects of Amputation in our community. Methods: It was a descriptive, quantitative, and prospective study of the indications and epidemiological characteristics of Amputations in Uyo, Niger Delta region of Nigeria. This was done between the periods of January 2018 to December 2019 amongst patients who underwent Amputation at the University of Uyo Teaching Hospital, Uyo, Nigeria. Results: We did a total of 44 unilateral amputations of both upper and lower extremities. The age range was 19 to 71 years. The average age was 48.5 years they were 21 males and 23 females giving a Male: Female ratio of 1:1.1. The 4th to 6th decades of life had the highest number of amputations with a peak in the 5th decade. Diabetic Foot Gangrene (DFG) contributed the majority of 25 amputations (56.8%), most of which were in the 4th to 6th Decades, 23 (52.3%). They were 14 females (31.8%) and 11 males (25.0%) with DFG. Trauma contributed 14 amputations (31.8%), and most were in the 2nd to 4th decades of life but more were males 10 (22.7%) while females were 4 (9.1%). Fracture-Traditional BoneSetter-Gangrene (F-TBS-G) and Peripheral Arterial Disease each contributed 2 amputations (4.5%). Conclusion: The commonest indication for amputation was Diabetic Foot Gangrene(DFG) affecting patients in the 4th to 6th decades of life while Trauma, the 2nd commonest, affected patients in the 2nd to 4th decades of life. Therefore, in the face of the increasing prevalence of Diabetes in our society, Public Health measures aimed at early diagnosis and management of Diabetes as well as prevention of Trauma will reduce the rate of amputations, its attendant morbidity, and negative economic implications in our society.