MAGNITUDE AND FACTORS ASSOCIATED WITH LIMB AMPUTATION AMONG ORTHOPEDIC PROCEDURES AT ARBAMINCH GENERAL HOSPITAL,GAMOGOFA ZONE, SNNPR, ETHIOPIA

Abstract

Limb amputation is devastating for those affected and is a significant factor in rising health care cost. In Ethiopia like other developing country trauma is the most causes of amputation. This is mainly due to late complication of trauma management like wet gangrene, gas gangrene and chronic osteomyelitis. The inappropriate use and care of splints (both bamboo and plaster) in the management of fractures by Medical Staff and Traditional Healer is one of factors associated with limb amputation. Objective: To assessMagnitude and associated factors oflimb amputation among orthopedic procedures at Arba Minch General Hospital fromSeptember 2014-Augst 30/2017. Methods: Facility based cross sectional study was used to conductthe study from cards of orthopedic procedures utilizing a three years data. Systematic sampling technique was used to select representative of 384 study subjects. Socio-demographic and limb amputation related information was reviewed from Patient medical records using Structured and pretested checklists.Epi-Info version 7.0 and SPSS version 21.0 was used for data entry and analysis respectively. Descriptive statistics and bivariate analyses were computed. Variables associated at bivariate logistic regression with significance level of P< 0.25 wereentered into multivariate logistic regression model and then variables with P <0.05 was considered statisticallyas significantassociation with limb amputation. RESULTS: From a total of 384 samples 61(15.9%) limb amputation were performed. The mean age of the study subjects were 27(SD + 17).Amputation was common in age group <18yr in 25(41%) patients followed 22(36%) in 19-37yrs. In this study amputation was more common in male 39(64%) than female 22(36%).independent variable like infection, time of arrival >7hr, pre hospital treatment, place of pre hospital visit diabetes mellitus and rural residence was found to have association with amputation at P<0.25. On Multivariate logistic regression infection (p=0.001 (AOR=24.311, 95%CI (5.868-75.045) and traditional healer treatment (P=0.001 (AOR=30.976, 95% CI (4.221-22.734) have significant association with limb amputation. CONCLUSION AND RECOMMENDETION:The study has revealed magnitude of limb amputation 15.9%. Infection and pre hospital treatment by traditional healer (wogesha) was found to be significantly associated with limb amputation. Developing appropriate strategy to prevent orthopedic infection and providing health education for traditional bone setters (Wogesha) on adverse effect of tight splint age of fracture and putting law enforcement to make them responsible for early referral of patients was recommended.