The indications for major limb amputations: 8 years retrospective study in a private orthopaedic and trauma centre in the south-east Nigeria

Abstract

Major limb amputation is a common orthopaedic trauma procedure and it is indicated mainly for traumatic gangrene and for trauma related limb conditions. The loss of a limb is devastating to the patient even when it is done to save life. The aims of the study are to highlight the indications for major limb amputations and to find out if there are any concurrent pattern changes. This is a retrospective study analysing medical records of all the patients, who had major limb amputations over a period of 8 years, between October 2007 and September 2015 in a private orthopaedic and trauma centre in the south-east sub-region of Nigeria. Traumatic gangrene was the commonest indication for amputation n=30 (44.7%), followed by diabetic gangrene n=15 (22.3%), and then traditional bone setters' gangrene n=10 (14.9%). These were trailed by mangled extremity, malignant conditions of the limb and polydactyl in that order of decreasing frequency. Traumatic gangrene and other trauma related limb conditions are the leading indications for amputation in this study despite some recent reports stating otherwise. Trauma is largely preventable and so there is a need for continued intensification of the public campaign on road use as a means of preventing severe limb injuries and thus reducing consequent need for amputations.