Study of Vascular Amputations At Kenyatta National Hospital

Abstract

This is a study of 120 vascular amputation patients operated on between January, 1981 and January, 1988 at Kenyatta National Hospital. Sixty-six (66) patients (55%) were amputated following trauma to the limbs. Twenty-three (23) patients (19.17%) were amput ated due to arterioscleros is of the lower limbs with ischaemic complications. Sixteen (16) patients (13.33%) had confirmed diabetes mellitus with diabetic ischaemic angiopathy. In seven patients (5.83%), investigations were incomplete and t he cause of ischaemia necessitating amputation was undetermined. There were two (2) patients (1.69%) who had confirmed venous gangrene. One patient developed lower limb gangrene following a snake-bite. Another patient developed gangrene of the toes while undergoing treatment for septic abc r tit.on , Amputation due to complicating vasculitis was observed in one patient with a chronic leg ulcer. Lastly, one patient developed gangrene of the lower limb after intramuscular injection in the anterior part of the thigh by a quack doctor. Of all the amputations done during the period of study at Kenyatta National Hospital 62.5% were vascular amputations. Sixt y-six (66) traumatic vascular amputations studied formed only 1.2% of a total of 5,500 patients who had trauma to the limbs during the period of study. The male to female ratio of the vascular amputees was 3: 1. The youngest patient was 4 years old and the oldest 84 years. There were a total of 80 (70.31%) lower limb amputation stumps and 33 (29.69%) upper limb amputations stumps. The overall mortality was 4.17%.