Lower limb amputations at the Kenyatta National Hospital, Nairobi

Objective: To determine the causes and pattern of lower limb amputations at the Kenyatta National Hospital. Design: Descriptive prospective study. Setting: The Kenyatta National Hospital between July 2003 and June 2004. Results: A total of 77 lower limb amputations (LLA) were performed on 74 patients. The age ranged from seven months to 96 years (mean 44.8 ± 22.5). Forty six patients (62.1%) were male. Majority of the patients (89.1%) had primary or no formal education, forty one (55.4%) were unemployed, with 39% self employed in the informal sector. Peripheral vascular diseases were the main indication for LLA (55.3%), 13 patients (17.5%) due to diabetes-related gangrene. Eighteen patients (24.3%) had tumours, mainly osteogenic sarcoma (16.2%), while trauma accounted for 18.9%. Forty two (55%) of the amputations were above-the-knee, 24 (31%) below-the-knee, four (5%) hip disarticulations and seven (9%) were foot amputations. Conclusion: This study found peripheral vascular diseases unrelated to diabetes to be the main indication for lower limb amputations at Kenyatta National Hospital contrary to previous institutional and loco-regional studies which report trauma as the leading cause. Further investigation into vascular causes is therefore recommended.