OBJECTIVE: To determine the pattern of lower limb amputation (LLA) and highlight preventable causes in our hospital. DESIGN: A retrospective study. SETTING: University Teaching Hospital, Jos, Nigeria. SUBJECTS: Eighty seven patients who had LLA over a five and a half year period. There were 62 males and 25 females aged between three and 83 years (mean+/-SD = 44.5+/-21.1). MAIN OUTCOME MEASURES: Indications, morbidity and mortality. RESULTS: A total of 94 LLA were performed in the 87 patients managed. Trauma, diabetic foot sepsis and malignant conditions of the limb were the main indications for LLA in 26(29.9%), 23(26.4%) and 20(23%) patients respectively. Others were peripheral vascular gangrene (PVG) in eight (9.2%) patients; chronic osteomyelitis, three (3.5%); chronic leg ulcers, three (3.5%); Ainhum, three (3.5%) and snake bite in one patient (1.1%). Above knee amputation (AKA) was the most common procedure performed (48.9%) followed by below knee amputation (BKA) in 37.2%. There were 11 deaths (12.6%), out of which eight were due to sepsis with multiple organ failure following diabetic foot sepsis, two cases of clostridial myonecrosis complicating compound fractures and a case of metastatic osteosarcoma in a child. CONCLUSION: Majority of the cases of LLA could have been avoided with early presentation and appropriate management. A case is made for community health education on the need for early presentation to hospital for limb lesions.
OBJECTIVE: To determine the pattern of lower limb amputation (LLA) and highlight preventable causes in our hospital. DESIGN: A retrospective study. SETTING: University Teaching Hospital, Jos, Nigeria. SUBJECTS: Eighty seven patients who had LLA over a five and a half year period. There were 62 males and 25 females aged between three and 83 years (mean+/-SD = 44.5+/-21.1). MAIN OUTCOME MEASURES: Indications, morbidity and mortality. RESULTS: A total of 94 LLA were performed in the 87 patients managed. Trauma, diabetic foot sepsis and malignant conditions of the limb were the main indications for LLA in 26(29.9%), 23(26.4%) and 20(23%) patients respectively. Others were peripheral vascular gangrene (PVG) in eight (9.2%) patients; chronic osteomyelitis, three (3.5%); chronic leg ulcers, three (3.5%); Ainhum, three (3.5%) and snake bite in one patient (1.1%). Above knee amputation (AKA) was the most common procedure performed (48.9%) followed by below knee amputation (BKA) in 37.2%. There were 11 deaths (12.6%), out of which eight were due to sepsis with multiple organ failure following diabetic foot sepsis, two cases of clostridial myonecrosis complicating compound fractures and a case of metastatic osteosarcoma in a child. CONCLUSION: Majority of the cases of LLA could have been avoided with early presentation and appropriate management. A case is made for community health education on the need for early presentation to hospital for limb lesions.
Authors: Phillipo L Chalya; Joseph B Mabula; Ramesh M Dass; Isdori H Ngayomela; Alphonce B Chandika; Nkinda Mbelenge; Japhet M Gilyoma Journal: J Orthop Surg Res Date: 2012-05-11 Impact factor: 2.359
Authors: Ian R Hambleton; Ramesh Jonnalagadda; Christopher R Davis; Henry S Fraser; Nish Chaturvedi; Anselm J Hennis Journal: Diabetes Care Date: 2008-11-04 Impact factor: 17.152