Major lower limb amputation and early functional outcomes; a tertiary hospital experience in eastern Tanzania

Background: The present study aimed to determine the indications and short-term complications of major limb amputations as well as early functional outcomes. Methods: This was a prospective, Descriptive Hospital based study conducted among 52 patients at Muhimbili Hospital complex between January 2022 and January 2023. Main Outcome Measures were patient survival, complications and early functional outcome following amputation. Results: A total of 52 patients were eligible for the study. The most common indication for major limb amputation was peripheral vascular disease with or without diabetes in 48% of patients. Trauma was the second most common cause of amputations in 40.4% of patients. Stump revision was common accounting for 29.6% of participants significantly contributed by stump infections. The mortality rate was 17.3%; septicaemia accounting for most of the observed deaths (44.4%). Of the 52 participants, 46.2% were independent in carrying out activities of daily living at final assessment with 61.5% of amputees acquiring prostheses at the end of study. Majority of participants failed to acquire prostheses because of poor stump qualities. Conclusion: Major lower limb amputation continues to result in significant perioperative morbidity and mortality. Preventive measures such education of diabetic patients on foot care and, public enlightenment on accident and trauma prevention strategies will go a long way in reducing the burden of amputation. Making prosthesis available and affordable to amputees is also suggested as a way of improving on the quality of life and functionality of amputees.