Indications and Complications of Limb Amputation in Tamale, Ghana

Background: Amputation is the removal of whole or part of a limb or any body part by cutting through a bone, a joint or that body part. The permanent loss of these body part(s) exert stress physically, emotionally, psychologically and economically on the patient, his family and the society at large. The incidence and indications of limb amputations varies. The objective of this study was to determine and high-light the indications and complications of limb amputations in Tamale, Ghana. Methods: a retrospective study covering a 5-year period, from January 2007 to December 2012, involving 160 patients was undertaken, in Tania specialist hospital, Tamale, Ghana. Patients medical records were retrieved and examined, considering demographic factors including age and gender, Level of amputation, indications for amputation, complications after amputation and the final outcomes were also determined. The post-operation follow-up schedule was as follows; end of first week, end of first month, end of third month and end of sixth month. The inclusion criteria of all participants were; all cases referred or not referred to Tania specialist hospital from January 2007 to December 2012 who had limb amputations performed in Tania specialist hospital. Also those with previous amputation(s) done elsewhere qualified for the study if there was a written referral letter indicating the indications for that amputation and if the reasons for that referral (complications) were clear to us. Results: a total of 160 patients were recruited for the study. These patients were between the ages of 2 and 70 years, with a male to female ratio of 4:1. There were 160 unilateral limb amputations. The sites of amputation were lower limb 131 patients (81.88%) and upper limb 29 patients (18.14%), the main indications for amputation were severe trauma, 50 (31.25%), gangrene, 32 (20.0%), compartment syndrome 25 (15.63%). Of the other indications, malignant tumors were 12 (7.5%), The commonest complications after amputation were wound infections 10 (6.25%) and depression 5 (3.13%). There were no deaths or tetanus cases recorded. Conclusion; males were four times at risk of been amputated and lower limb to upper limb amputation ratio was 4:1. The main indications for limb amputations were severe trauma, gangrene and compartment syndrome. Councelling services should be provided to patients both pre-operatively and post-operative to help prevent and/or manage the depression.