Causal conditions for major limb amputation at a specialist hospital in north central Nigeria

Background: Amputation is said to be a mutilating surgical procedure with causes varying within and between countries. Even though most causes of amputation result from potentially preventable conditions, it is one of the most commonly performed procedures. The aim of this study is to elucidate the of causes of major limb amputation at NKST Rehabilitation Hospital, Mkar , Benue State so as to proffer preventive measures.Methodology: Case records of patients who had major limb amputation between January 2007 and December 2011 at NKST Rehabilitation Hospital, Mkar, were retrieved from the Medical Records Department and analyzed for age at time of amputation, gender, indication for amputation, and early complications following surgery.Results: A total of 198 major limb amputations in 198 patients were audited. There were 139(70.2%) males and 59(29.8%) females with an age range of 2-85 years. The causes of major limb amputation included trauma (n=122, 61.6%), diabetic foot disease (n=36, 18.2%), musculoskeletal tumours (n=26, 13.1%) and peripheral vascular disease (unrelated to diabetes) (n=10, 5.1%). Traditional bone setters' gangrene was the predominant cause (n=65, 53.3%) of traumatic amputation. Surgical site infection was the leading early complication(n=63, 31.8%).Conclusion: Trauma and diabetic foot disease were the leading causes of major limb amputation from the study. Regulating traditional bone setters' practices, enforcing road safety regulations and adequate diabetic foot care practices are recommended.Keywords: Major limb amputation, Indications, TraumaJos Journal of Medicine, Volume 7 No.

The profile of trauma-related mortality in Benue State University Teaching Hospital, Makurdi, Nigeria

Background: Trauma is globally associated with significant mortality with   developing count r ies bearing a disproportionately high burden. This study aims to elucidate the pattern of trauma-related deaths in Benue State University teaching hospital (BSUTH), Makurdi, Nigeria.Methods: A review of all trauma-related in-hospital deaths from July 2012 to December 2014 was carried out. Patients' socio-demographic and injury-related data were extracted and analyzed using IBM SPSS Statistics for Windows, Version 21.0.Results: One thousand and nine trauma patients were attended to during the study period of which 87 (8.7%) died during the hospital stay. Eighty-five trauma-related deaths were included in the study comprising of 67 males (78.8%) and 18 females(21.2%). The predominant age group involved was 20-29 years. Road traffic injuries (RTI) were the leading cause of fatal injuries accounting for 76.5% of deaths  (n=65). They were followed by burns (n=8, 9.4%) and gunshot injuries (n=6, 7.1%).. The  locations of deaths within the hospital were the Accident and Emergency Department (A&E) (n=60, 70.6%), wards (n=18,  21.2%) and intensive care unit (n=, 7.4%). The main causes of death were traumatic brain injury (TBI) (n=60, 71.4%), exsanguination (n=8, 9.5%), chest injury (n=5, 6.0%) and multiple organ dysfunction syndrome (MODS); n=3, 3.6. Fifty-three patients (62.4%) died within the first 24 hours of arrival at the hospital (early deaths). Patients with TBI were more likely to die within 24 hours of admission than those who have stayed for more than 24 hours in the hospital. (p = 0.001).Conclusions: Trauma-related mortality in BSUTH affected 20- 39 year old males predominantly. Majority of lethal injuries were caused by road traffic accidents with traumatic brain injury being the leading cause of death.Keywords: Trauma, Injury, Deaths, Pedestrians, Pediatric death