Is there a changing trend in the Etiology of major lower limb amputation in the developing nations?

Author(s): Shem B Yilleng, Mike B Ode, David G Mancha, Idumagbodi Amupitan, Ichia I Onche and Femi O Taiwo

Abstract: Background: Amputation is the removal of part or the whole of a limb and when done on the lower limb proximal to or at the ankle is called major lower limb amputation. Specific indications include trauma, peripheral vascular disease, tumor, infection and congenital anomalies and others. The mortality rate is especially high in those with peripheral vascular disease, also high are complications concerning stump healing, and difficulty in rehabilitation. There seem to be some changing trend in the etiology of lower limb amputation in the developing nations which if reported at all is under. The study sets to determine if there is a changing trend in the indications of lower limb amputation to enable planning by the hospital towards improving services and to influence government policy in Terms of instituting preventive measures. Multi disciplinary team approach to rehabilitation offers the most effective means for successful re-integration of the patient with an amputated limb to their previous life style
Methods: Folders of patients perused for information as regards their bio-data, indications, clinic-pathological variables and early outcome of managements. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 16.0 for windows. Frequency distribution tables of variables were generated and chats formed. Measure of central tendency and dispersion of quantitative variables as well as proportion for qualitative variables were determined.
Results: Age ranged was 18-82years with a mean age of 52.61±19.03. Majority were of the working age group 18-60yrs (94.4%).
There were 53(67.1%) males with a male: female ratio of 2.04:1
Peripheral vascular disease accounted for 70.5% of the patients followed by trauma (19.2 %). Thirty seven (46.8%) had below knee amputations.
Seventy one (89.9%) of them were discharged home, 3(3.8%) signed against medical advice and left while 5(6.3%) died.
Conclusion: The etiology of major lower limb amputation is really changing towards what we normally see in the developed nations with peripheral vascular disease taking over from trauma as the major cause of amputation and not only is it changing it comes with its documented unwanted consequences such as high morbidity and mortality.

DOI: https://doi.org/10.22271/ortho.2022.v8.i1i.3080