Is the Race Still between Trauma and Diabetes? - Reviewing the Most Common Reasons for Lower Limb Amputations in Nigeria

Abstract

Background: Lower limb amputation is a major healthcare concern globally, particularly in Nigeria, where trauma and diabetes mellitus (DM) are significant contributors. This study aimed to assess the causes of above-knee amputations at the National Orthopaedic Hospital Igbobi, Lagos, from 2011 to 2020, re-examining whether trauma and diabetes remain the predominant factors in the context of changing healthcare dynamics and demographic shifts. Methods: This retrospective cross-sectional study analyzed the medical records of patients who underwent above-knee amputations between 2011 and 2020 at the National Orthopaedic Hospital, Lagos. Data were extracted on demographic information and the primary causes of amputation. Descriptive analysis was conducted using SPSS. Results: Of the 541 patients who underwent lower limb amputations, 280 had above-knee amputations. Diabetic foot syndrome (DMFS) was the leading cause (43.4%), followed by trauma (31.4%). Other causes included peripheral vascular disease (8.3%) and malignancies (6.7%). The male-to-female ratio was 3.5:1, with the majority residing in urban areas. Conclusion: Despite advancements in healthcare, trauma and diabetes remain the leading causes of above-knee amputations in Nigeria. Comprehensive interventions targeting both preventive care and healthcare system improvements are essential to address this public health challenge.