Profile of Major Limb Amputations in Zaria, North West Nigeria: An Emerging Trend in a Dynamic Nation

Abstract

Background: Amputation has been used for both punitive and therapeutic measures. The therapeutic indications vary and the predominant ones in a locality are the products of some local factors, and changes with the dynamics of the local factors.

Objective: To investigate the profile of major limb amputations in our institution and thence suggest possible ways of reducing the major indications.

Materials and Methods: Design: Asix-year retrospective observational study. Setting: The Orthopedicsurgery department of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. The hospital has about 1000 bed capacity and serves as a referral center to the adjoining states of the north-western and north-central Nigeria. Subjects: All patients who had major limb amputations.

Results: Two hundred and one patients' case notes were reviewed. Three of the patients  had bilateral amputations, bringing the total number of amputations analyzed to 204. 19.6% were children (< 18 years), while 80.4% were adults. The male: female ratio was 2.7:1. Amongst the adult population, diabetic foot disease was the commonest indication for lower limb amputations, 55 (42.3%), while traumatic gangrene /mangled extremity was the commonest indication for upper limb amputation, 9 (42.9%). Traditional bone setters' gangrene was the commonest in children. Non­ diabetes-related peripheral vascular disease accounted for 19 (9.3%)amputations.

Conclusion: Disease conditions associated with western life-style and diet are now dominant indicationsfor amputation in adult Nigerians; while those in children remain unchanged. This calls for an aggressive public enlighten­ ment against the adverse outcome of traditional bone setting and western-type diets.