Major limb amputations: an audit of indications in a suburban surgical practice.
BACKGROUND
Advancements in vascular and microsurgery in developed countries have led to fewer major limb amputations.


OBJECTIVE
This audit of major limb amputations performed at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, between June 1998 and May 2003, was conducted to find out the indications for amputation and highlight those cases that could be salvageable.


METHODS
This was a retrospective study. Case notes of all patients who had major limb amputations were examined for patients' age, sex, time of presentation, limb affected, indications for amputation, the severity of crush injury to limb, stage of musculoskeletal tumors and Wagner's grade of diabetic foot.


RESULTS
A total of 71 limbs were amputated in 69 patients; 56 limbs (78.1%) were unsalvageable, while 15 limbs (21.1%) were salvageable. Trauma accounted for 76% followed by 22% performed due to gangrene secondary to diabetes mellitus. Out of the 56 unsalvageable limbs, 31 patients presented with severely crushed limbs. Out of the 15 salvageable limbs, there were 11 cases of clean-cut traumatic amputations, two of soft-tissue sarcoma and one each of ruptured popliteal aneurysm and stenosed popliteal artery.


CONCLUSIONS
Trauma and diabetes mellitus were leading indications for amputation. Expertise in limb salvage procedures and availability of appropriate equipment may reduce the numbers of amputations performed.
Akiode
Olutola
O
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. tolakiode@yahoo.com
Shonubi
A M Olusola
AM
Musa
Adewale
A
Sule
Ganiyu
G
D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D000673:Amputation, Traumatic / Q000453:epidemiology; D001859:Bone Neoplasms / Q000453:epidemiology / Q000601:surgery; D003906:Developing Countries; D017719:Diabetic Foot / Q000453:epidemiology / Q000601:surgery; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D009549:Nigeria; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D016879:Salvage Therapy
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