Major limb amputations at a teaching hospital in the sub-Saharan Africa: Any change in trend?

Background: Major limb amputation is a serious but usually pre ventable public health problem that is often associated with profound social, psychological and economic impacts on the patient and family. The objective of this study was to evaluate the trend, indications and short term complications of major limb amputations and to compare our experience with that of other published data.
Methods: A retrospective study of medical records of all patients who underwent major limb amputations at a Nigeria teaching hospital between 2006 and 2013. Information about age, sex, indications, level of amputation, facilities where patients had initial care before presenting in our centre, complications and outcomes of care were studied.
Results: One hundred and sixty-five major limb amputations were done in 158 patients with bilateral lower limb amputations in seven of them. 60.8% of these were due to severe extremity trauma with irreversible vascular damage while diabetic foot gangrene accounted for 30.4%. Complications included wound infections (24.2%), flap necrosis (3.6%), phantom limb pain (2.4%) and knee flexion deformity (0.6%). Mortality was 0.2%.
Conclusion: Trauma with irreversible vascular damage is still the leading indication for major limb amputation in our hospital.