Lower limb amputations at the Kenyatta National Hospital, Nairobi

To determine the causes and pattern of lower limb amputations at the Kenyatta National Hospital.Descriptive prospective study.The Kenyatta National Hospital between July 2003 and June 2004.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.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.