Problems of amputation surgery in a developing country.
We studied prospectively 87 patients who underwent extremity amputation in the National Orthopaedic Hospital in Lagos in 1995-1996. Trauma from road traffic accident was the most common indication (34/87) with peripheral vascular disease being the least encountered (2/87). Traditional bonesetters' gangrene accounted for 9/87 cases in circumstances that were largely avoidable. Our study revealed that amputation is still being performed as a life-saving procedure, as 44/87 patients presented with gangrene of a limb. The nonavailability of special investigations such as Doppler ultrasound, arteriography, and CT scan was responsible for a delay in definitive treatment in 28 cases. Poor prosthetic services and the absence of a well-coordinated amputee clinic were responsible for some of the unsatisfactory results. We believe that the availability of specialized diagnostic tools and facilities for microvascular surgery, together with a multidisciplinary approach to the management of the amputee, would considerably change the current gloomy picture of amputation in developing countries such as Nigeria.
Yinusa
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Department of Orthopaedics and Trauma Surgery, National Orthopaedic Hospital, Igbabi, PMB 2009, Yaba Lagos, Nigeria. boboyinus@hotmail.com
Ugbeye
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ME
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000523:psychology / Q000534:rehabilitation / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011446:Prospective Studies