Forequarter amputations at the Moi teaching and referral hospital

Abstract

Background : Forequarter amputation is an uncommon procedure. It is performed for high grade sarcomas of the proximal humerus, scapula and axillary region; that are not responding to induction chemotherapy or tumour progression with vascular invasion. Objective : To document the indications and results of forequarter amputations done at the Moi Teaching and Referral Hospital. Methods : Records of patients that had received a forequarter amputation in Moi Teaching and Referral Hospital between February 2012 and February 2017 were retrieved. The patient’s demographics, indication for surgery, complications and duration of survival post-operatively were noted and further analyzed. Results : A total of twelve patients were found that had a forequarter amputation done on their upper extremity. Eight were male while four were female. Ten patients (83.3%) were operated on for sarcomas including: synovial sarcoma, neurofibrosarcoma, Ewing’s sarcoma, Kaposi’s sarcoma, rhabdomyosarcoma, enchondroma, osteosarcoma and poorly differentiated sarcoma. Two patients (15.4%) were operated for squamous cell carcinoma. All the amputations were primary surgeries. Survival was 77.7% at six months and 44.4% after one year. Conclusion : The most common indication for forequarter amputation was a limb sarcoma. A one-year survival rate of 44.4% was found following forequarter amputation of a limb.