This study analyzed 15 cases of lower limb amputations performed at Kenyatta National Hospital in Kenya over a six-week period. The most common indication for amputation was diabetic foot gangrene, accounting for over half of cases. Elderly patients over 60 years old made up more than 30% of amputees due to diabetic gangrene of the foot. The study recommends increased patient education and counseling, as well as establishment of rehabilitation programs, to address the psychological and economic impact of amputations.

1. AMPUTATION AS SEEN IN AN
ORTHOPAEDIC WARD IN KENYA
Were ID; Mutiso VM; Ating’a JEO;
Otsyeno FMT
Affiliation KNH/UON/AORF

2. Introduction
• Amputation is a psychological, social and economic
tragedy for the patient and his/her family.
• In an environment where rehabilitation facilities
are not well developed, the operation becomes a
dreaded procedure
Indications
– Vascular Disease and Diabetes
– Trauma
– Frostbite
– Tumors
– Congenital

3. Subjects & Methods
• This study aimed at ascertaining the patterns
of lower limb amputation at Kenyatta National
Hospital with regards to indications for
surgery and levels.
• Review of all cases of lower limb amputations
done in Firm III Orthopaedics at Kenyatta
National Hospital over a six weeks period
between 15th February 2013 and 31st March
was done

4. Results
• There were 15 cases available for study 13 eventually being
enrolled
• Two refused to give consent for the study
• The age range was 26 to 72 years, mean age of 41.2 ± 10.6 years
• The male:female ratio was 2:1
• Of the two patients who refused to give consent the diagnosis was
tumor in one the other was a mangled extremity.
• Time taken to get consent ranged between two days and eleven
days with an average of 5 days.
• The level of amputation appeared to have been governed by the
pathology.
• One patient with diabetic foot who underwent below knee
amputation had to undergo above knee revision amputation.

5. Figure 1: Graph showing type of amputations in %
69.2
30.8
Trans-tibial amputation Trans-femoral amputation
POPULATION
IN %
TYPE OF AMPUTATION
TYPE OF AMPUTATIONS

6. Figure 2: graph showing indications for amputation in %
53.8
23.1
7.7 7.7 7.7
DIABETIC FOOT GANGRENE TUMOUR INFECTION TRAUMA FROST BITE
Population
in %
INDICATIONS
INDICATIONS FOR AMPUTATION

7. Figure 3: Graph showing distribution of patients who underwent
amputation by age
0 0
2 2
4
5
Newborn 2wks-5yrs 6-12yrs 13-24yrs 25-59yrs >60yrs
No. of Patients
Life cycle cohort
Ages of Patients

8. Conclusions
• The elderly patients(>60yrs) constitute more
than 30% of amputees, consequent to
Diabetic gangrene foot.
• Patient education, counselling and
establishment of rehabilitation programs for
children are recommended

9. References
• Awori KO, Atinga JEO. Lower limb amputations
at the Kenyatta National Hospital. Nairobi East
Afr Med J 2007;84:121–126
• Ogeng'o JA, Obimbo MM, King'ori J. Pattern of
limb amputation in a Kenyan rural hospital. Int
Orth 2009;33:1449–1453