Experience with accelerated ponseti technique for treatment of idiopathic clubfoot in a regional orthopaedic hospital in Nigeria.

Introduction: Idiopathic talipes equinovarus (ITEV) 'aka clubfoot' is the most common foot deformity in children. Ponseti technique had been accepted as a standard method for correction. The traditional Ponseti technique for correction is well known. Accelerated Ponseti technique is said to offer some advantages over the standard technique. The aim of this study was to determine and document the efficiency and success rate of accelerated Ponseti technique. Methods: This was a prospective interventional study which lasted 26 months from February 2017 to April 2019. Twenty-eight patients with 42 feets who met the inclusion criteria were recruited. They had serial manipulation and casting twice every week till percutaneous tenotomy was done as indicated. Final cast usually applied after tenotomy and left for 3weeks. Each patient was followed up for a year corresponding to 9 months after the commencement of night bracing. Data were analysed using SPSS version 20. Results: The mean age was 8.1 months with a range of 1-36 months. The mean Pirani score recorded was 4.4, while the mean number of casting sessions was 3.6 and the mean duration of treatment was 12.4 days. The tenotomy rate recorded was 42.9%. Pre-bracing assessment of Pirani score, passive ankle dorsiflexion and foot abduction done and repeated after a year revealed optimal correction. The relapsed rate at 1 year was 4.8%. The only complication observed was pressure sore in a patient. Conclusion: The accelerated Ponseti technique is an efficient method of treatment of ITEV in a much shorter time with a higher success rate. It facilitates compliance with treatment.

Analysis of risk factors for wound infection after extremity fracture caused by machete cut in a resource-limited setting.

Background: Machete cut fracture is a unique subset of open fracture. The sharp force of a wielded machete that cleanly divides soft tissue envelope with minimal or no contusion results in an open fracture wound that is relatively less prone to infection. However, in resource-limited settings, the wound infection rate after machete cut fracture is relatively high. This study aimed to determine the risk factors for wound infection after extremity machete cut fractures in a Nigerian setting. Methods: We undertook a retrospective analysis of the patients who were seen in the Emergency room of two tertiary hospitals in Nigeria with a machete cut extremity fracture from 2009 to 2018. The association of wound infection with population and wound characteristics as well as intervention related factors were evaluated. Statistical significant factors for wound infection in the Univariable analysis were entered into a Multivariable regression analysis to evaluate the risk of each factor when adjusted to other factors. Results: There were 113 machete-cut fractured bones in 67 eligible patients and wound infection was a complication in 45 (39.8%) of the cases (95%CI 30.3 - 49.7%).The factors significantly associated with high wound infection rate were smoking, haematocrit < 30%, fractures sustained outdoors, lower extremity fractures, a wound size of >5cm in length, injury-to-hospital arrival interval > 6hrs. Multivariable regression analysis identified wound size >5 cm (aOR 14.142, 95%CI (2.716 - 73.636); p = 0.002), injury-to- hospital arrival interval later than 6hrs (aOR 4.410, 95% CI (1.003-19.394); p = 0.050) and administration of antibiotics later than 3hrs of injury (aOR 5.736, 95%CI (aOR1.362 - 24.151; p = 0.017) as independent risk factors for wound infection. Conclusion: Wound infection after open fractures caused by machetecut is more likely to occur in patients that present later than six hours after injury, wounds more than 5cm in length and delayed antibiotic administration. Appropriate treatment protocols can be instituted with this knowledge.

Prevalence and risk factors for low back pain during pregnancy among women in Abakaliki, Nigeria.

INTRODUCTION: low back pain (LBP) during pregnancy is an important health concern among women globally. The prevalence and risk factors for LBP in pregnancy vary from and within sub-regions and have implications in preventive and treatment strategies. In West African sub-region, there is scanty data on LBP during pregnancy. This study aimed to determine the prevalence and predisposing factors for LBP during pregnancy in this environment. METHODS: this was a cross-sectional study carried out among pregnant women admitted into the Labour Ward of Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria over a period of 8 months. They were interviewed within 2 to 7 days postpartum with a questionnaire. Sociodemographic and obstetrics characteristics as well as LBP intensity, features and associated factors were evaluated. Significant factors for LBP that emerged from the univariable analysis were entered into multivariable regression analysis to evaluate the risk of each factor when adjusted to other factors. RESULTS: of the 478 women interviewed, 138 (28.9%) of them (95% CI 25.1-33.1) reported LBP in the index pregnancy. The onset of pain was predominantly in the third trimester and the mean pain intensity was 4.3 ± 1.36. In the univariable analysis, six factors were significantly associated with LBP. Logistic regression analysis identified LBP in previous pregnancy (aOR: 24.76, (95% CI 6.88-89.11); p< 0.001), macrosomia (aOR: 4.15(95% CI 2.05-8.42); p< 0.001) and absence of domestic help (aOR: 0.50(95% CI 0.31-0.82); p=0.006) as independent risk factors for LBP during pregnancy among the women. CONCLUSION: in this study, LBP during pregnancy is within worldwide range and predominantly mild to moderate in intensity. The independent risk factors identified call for high priorities accorded to women with these factors in measures aimed at addressing LBP during pregnancy.

Firearm Injury Among Children and Adolescents in Nigerian Civilian Trauma Setting: Prevalence, Pattern, and Implications for Prevention.

Firearm injury in children and adolescents and the morbidity associated with it is an appreciable burden in resource-limited settings, though it is under-reported. This study aimed to determine its prevalence and pattern in Nigerian civilian trauma setting. We undertook a retrospective study of all the patients with firearm injury aged 19 years or under who visited the Emergency Department (ED) of two tertiary hospitals in Nigeria over a period of 15 years. Of the 46,734 children and adolescents seen in the ED, firearm injury was the reason for the visit in 56 of them, giving a prevalence of 1.2 per 1000 ED attendance (95% CI: 0.9-1.6). The male-to-female ratio was 1.8:1, and the mean age was 13.98 ± 5.6 years. The preponderance of firearm injury was in the rural areas, during the dry season, at home, and in the daytime. Armed robbery (20, 35.7%) and communal clash (7, 12.5%) were the two topmost incidents leading to gunshot wounds. Armed robbery-related gunshot occurred mostly on the roads and at nighttime and involved predominantly 15-19-year-olds. Lower extremity was the topmost anatomical region involved. The majority (67%) had no pre-hospital care; the mean and median injury-hospital arrival interval respectively was 352 hrs and 4.2 hrs. Wound infection was the topmost complication. The mean hospital length of stay was 22.6 days. One (1.8%) of the patients died on the third day of hospital admission. Educational campaigns for prevention intensified during the dry season should highlight the risk of firearm injury to this age group and emphasize the importance of proper supervision and guidance of vulnerable children and adolescents. Improving the rates of pre-hospital care and early presentation of victims to the hospital should be considered in tertiary injury prevention strategies.

Analysis of machete cut fractures in Nigerian civilian trauma setting.

Machete cut fracture is an important component of morbidity associated with machete injuries although it is under reported. This was a retrospective study to assess machete cut fractures in patients seen in Federal Teaching Hospital Abakaliki and National Orthopaedic Hospital Enugu from 2009 to 2018. There were 91 patients with 154 fractures, male- to- female ratio was 10:1 and mean age was 31.6 ± 14.6 years. The aetiological factors were assault (57, 62.6%), armed robbery (29, 31.9%) and accidental injury (5, 5.5%). The three top bones involved were ulna, metacarpal and finger-phalanx. Fracture was communited in (17, 11.0%), and Gustilo Anderson grade IIIC in (22, 14.3%). Injury to hospital arrival interval later than 6 h was common and correlated with prolonged length of hospital stay (p < 0.001). Anaemia, wound infection and hemorrhagic shock were the three top complications. Nine (5.8%) fractures ended in extremity amputation. Eleven (12.1%) patients left against medical advice, and 5 (5.5%) were transferred. Normal union in 98.3% of the fractures treated and followed up for a minimum of one year. Case fatality rate was 2.2%; none of the patient that died had pre hospital care, and hemorrhagic shock accounted for all the mortality. These call for appropriate injury preventive mechanisms, and improved rates of early presentation of patients to hospital, and pre hospital care.

Delay of Surgery Start Time: Experience in a Nigerian Teaching Hospital.

BACKGROUND: Operating room delay has multiple negative effects on the patients, surgical team, and the hospital system. Maximum utilization of the operating room requires on-time knife on the skin and efficient turnover. Knowledge of the reasons for the delay will form a basis toward proffering solutions. PATIENTS AND METHODS: This was a prospective study of all consecutive elective cases done over a 15-month period from January 2016 to March 2017. Using our departmental protocol that "knife on skin" for the first elective case should be 8.00am, the delay was defined as a surgery starting later than 8.00am for the first cases while the interval between the cases of >30 min for the knife on the skin was used for subsequent cases. Reasons for delay in all cases of delay were documented. The prevalence and causes of the delays were analyzed. P < 0.05 was considered statistically significant. RESULTS: Of 1178 surgeries performed during the period of study, 1170 (99.3%) of cases were delayed. The mean delay time was 151 min for all cases. First on the list had a longer delay time than others; 198.9 min versus 108.5 min (P = 0.000). Delay in the first cases accounted for 47.5% of all delayed cases. Overall, patient-related factor was the most common cause of delay (31.3%) followed in descending order by surgeon-related factor (28.5%) and hospital-related factor (26.2%). Patient-related factors accounted for 43.2% of first-case delays. CONCLUSION: Delays encountered in this study were multifactorial and are preventable. Efforts should be directed at these different causes of delay in the theater to mitigate these delays and improve productivity.

Abdominoplasty for male truncal obesity: case report.

Truncal obesity and its associated health risk is an enormous burden. The traditional surgical treatment modality is liposuction or lipoabdominoplasty. An uncommon mode of the treatment is the use of abdominoplasty alone or as a surgical component. The aim of this report is to show a satisfactory outcome of abdominoplasty as the only surgical component in the management of severe truncal obesity in elderly male patient. We report a 75 year old Nigerian trader who had truncal obesity with gross abdominal asymmetry and cardiovascular and diabetes mellitus co-morbidities as well as bilateral knee osteoarthritis and social isolation due to truncal disfigurement. He was offered abdominoplasty as a sole surgical option for correction of anterior abdominal wall asymmetry. Apart from post operative wound complications and blood transfusion reactions, the patient had a good recovery and improved quality of life. Abdominoplasty is a rewarding treatment when used as a sole surgical option in centrally obese patients with anterior abdominal wall asymmetry and significant subcutaneous fat thickness.

Incidence and Pattern of Extremity Fractures seen in Accident and Emergency Department of a Nigerian Teaching Hospital.

BACKGROUND: Extremity fracture is an important component of musculoskeletal injury worldwide. The distributions of etiological factors and types of extremity fractures vary from and within subregions and have implications in preventive and treatment strategies. This study aimed at determining the incidence and pattern of extremity fractures seen in accident and emergency department (A and ED) of a teaching hospital in a developing country. PATIENTS AND METHODS: This was a prospective study of all patients with extremity fractures seen in A and ED of Federal Teaching Hospital Abakaliki over 12 months between February 1, 2016 and January 31, 2017. RESULTS: Extremity fractures necessitated visit in 251 patients with 306 fractures giving an incidence of 22.6/1000/year of A and ED attendances (39.2/1000 males and 9.2/1000 females), with age range of 2-90 years and a mean of 35.6 ± 16.7 years. Road traffic accident (RTA) (184, 73.3%), fall from height (23, 9.2%), and gunshot (13, 5.2%) were the three top causes of fractures, whereas tibia, femur, and humerus were three top bones involved. Of the 306 fractures, 270 (88%) involved the long bones, 193 (63.1%) were close, and 113 (36.9%) were open fractures. Forty-four (17.5%) of them were multiply injured patient and head injury in 32 (12.8%) the topmost associated injury. One hundred and ninety-four (77.3%) were admitted into surgical ward and 28 (11.2%) self-discharged against medical advice. CONCLUSION: Appropriate preventive mechanisms based on the observed pattern is needed; a policy response to curb the menace of RTAs may invariably reduce the incidence of extremity fractures. Treatment strategies entail appropriate facilities and skilled workforce to deal with fractures of varying degrees of severity and complexity observed.

Clinical Outcome of Nonoperative Treatment of de Quervain's Disease with Local Corticosteroid Injection in Nigerian Setting.

BACKGROUND: The goal of treatment of de Quervain's disease, pain relief and restoration of hand functions, is achievable with local corticosteroid injection. However, published reports indicate variations in its cure rate and efficacy from and within subregions. This study aimed to determine the outcome of this treatment modality in Nigerian setting. PATIENTS AND METHODS: Fifty-one cases of de Quervain's disease in 41 consecutive eligible patients were enrolled between January 2011 and December 2016, treated with local methylprednisolone acetate injection and followed up prospectively in orthopedic clinics of Federal Teaching Hospital, Abakaliki, and Mater Miserere Cordiae Hospital, Afikpo, Nigeria. RESULTS: Eight weeks post initial injection, 94% of the cases were signs and symptoms free. The recurrence rate post initial injection (19.6%) correlated directly with pain intensity (P < 0.001) and was significantly (P = 0.018) higher in subacute compared to acute and chronic presentations. At the end of a follow-up period that ranged from 24 to 84 months with a mean of 54 months, 47 (92.2%) cases were cured with either single injection (78.4%) or multiple injections (13.7%) of corticosteroid, 3 (5.9%) had incomplete resolution but were satisfied, and in 1 (2%) there was no beneficial response. There was no serious adverse reaction; 14 (27.5%) cases had localized skin depigmentation. CONCLUSION: In our setting, local corticosteroid injection as a treatment modality for de Quervain's tenosynovitis has short- and long-term success rates of over 90%, and is rarely associated with serious adverse reaction. It is recommended as the initial treatment of choice in de Quervain's disease.

Analysis of risk factors for depression among patients with chronic low back pain in an orthopaedic clinic of a Nigerian teaching hospital.

BACKGROUND: Depression compounds the burden of chronic low back pain and has implications on the outcome of treatment. Published reports demonstrated a strong association between depression and chronic low back pain. However, there is very scanty data on predisposing factors for depression among these patients. OBJECTIVE: To determine the risk factors for depression among patients with chronic low back pain in a Nigerian orthopaedic clinic setting. METHOD: Three hundred (300) eligible, consenting and consecutive patients with chronic low back pain in orthopaedic clinic of Federal Teaching Hospital Abakaliki Nigeria were interviewed with Population and Pain Characteristics Questionnaire, General Health Questionnaire (GHQ-12) and Major Depressive Episode of Mini-International Neuropsychiatric Interview (M.I.N.I) over a period of 34 months. Statistically significant factors that emerged from Pearson chi-square test of association were entered into logistic regression analysis to evaluate the risk of each factor when adjusted to other factors.Depression was observed in 61(20.3%) of the patients interviewed. Seven factors for depression among these patients emerged from chi square test of association. Logistic regression analysis identified alcohol consumption, severe pain intensity, hypertension co-morbidity and prior traditional healer care as the independent risk factors for depression among the patients. CONCLUSION: The independent risk factors for depression identified in this study calls for maintaining a high level of suspicion in the patients with these risk factors to facilitate early recognition of depression, and a high priority accorded to them in the measures aimed at addressing depression for a good therapeutic outcome.

Childhood Pyogenic Osteomyelitis in Abakaliki, South East Nigeria.

BACKGROUND: Pyogenic osteomyelitis is an important child health problem in developing countries. It is a one-disease state with a spectrum of pathological features and clinical forms ranging from acute to chronic presentation. Its pattern of presentation varies from and within subregions. The aim of this study was to determine the pattern and outcome of childhood pyogenic osteomyelitis in a low-resource environment. MATERIALS AND METHODS: This was a retrospective study of all the children aged 18 years and under seen with pyogenic osteomyelitis in Federal Teaching Hospital Abakaliki between January 2005 and December 2015. RESULTS: In 76 patients, there was pyogenic osteomyelitis involving 85 bones. Female-to-male ratio was 1:1.7, and the mean age was 9.9 ± 5.1 years. The clinical forms of presentation were acute in 16 (21.1%), subacute in 10 (13.2%), and chronic in 50 (65.8%) patients. Acute osteomyelitis was the more likely form of presentation among infants (P < 0.001) and urban children (P < 0.011) whereas subacute and chronic osteomyelitis were more likely among the older children (P < 0.001) and rural residents (P < 0.011). Staphylococcus aureus was the most common isolated pathogen. Anemia, septic arthritis, and pathological fractures were the three top complications observed. Fifty patients (65.8%) recovered and adjudged cured, 9 (11.8%) were lost to follow-up, and 17 (22.4%) were unable to afford the financial cost of the treatment. CONCLUSION: In our environment, chronic pyogenic osteomyelitis sequel to acute hematogenous bone infection in childhood is common. Poverty is also a limiting factor in its definitive treatment. These calls for a policy response aimed at improved care and preventive strategies based on the observed pattern.

Incidence and Pattern of Dog Bite Injuries Treated in the Emergency Room of a Teaching Hospital South East Nigeria.

BACKGROUND: Dog bite injury treated in the emergency room varies from and within subregions in pattern and potential risk of transmission of rabies. This variation has implications in its morbidity and mortality. The aim of this study was to determine the incidence and pattern of dog bite injuries treated in a teaching hospital emergency room setting of a developing country. PATIENTS AND METHODS: This was a retrospective study of the entire patients with dog bite injury treated in the emergency room of Federal Teaching Hospital Abakaliki from January 2006 to December 2015. RESULTS: Dog bite injury necessitated visit in 74 patients with an incidence of 2 per 1000 emergency room attendances, and a male to female ratio of 1:1.1. The mean age of the patients was 25.5 ± 1.87 years, and peak age group incidence was 5-9 years. Lower extremity was involved in 77.5% of the injuries, and buttock was the predominant site of injury in 0-4 years old. Fifty-one (68.9%) owned dogs and 23 (31.1%) stray dogs were involved in the attack. There was unprovoked attack in 81.1% of cases, and 51 (68.9%) sustained Grade II injury. Twenty-eight (37.8%) of the dogs had anti-rabies vaccination. Fifty-four (73%) patients had no prehospital care while 64 (86.5%) received postexposure anti-rabies vaccine. Majority of the patients 73 (98.7%) recovered fully. One (1.4%) patient that presented with clinical rabies self-discharged against medical advice. CONCLUSION: The incidence of dog bite injury is within worldwide range though the female gender bias is unprecedented. We recommend preventive strategies based on the observed pattern and improvement in the rate of prehospital care and higher coverage of anti-rabies vaccination of dogs.

Childhood Pyogenic Septic Arthritis as Seen in a Teaching Hospital South East Nigeria.

BACKGROUND: Childhood pyogenic septic arthritis and its associated musculoskeletal morbidity is an important health concern in developing countries. Its pattern of presentation that varies from and within subregions has implications on the early recognition, treatment, and outcome. The aim of this study was to determine the pattern and outcome of childhood septic arthritis in our environment. MATERIALS AND METHODS: This was a retrospective study of all the children seen with pyogenic septic arthritis in Federal Teaching Hospital Abakaliki between January 2005 and December 2015. RESULTS: Childhood septic arthritis accounted for 44 (83%) of the 53 patients seen with pyogenic septic arthritis. Female to male ratio was 1:1.75 and the mean age was 5.7 ± 0.73 years. Eight patients (18.2%) had polyarticular involvements. The right shoulder was significantly more involved than the left and the left hip more than right. Overall, there was a preponderance of onset of symptoms in the dry season. Children from the rural areas accounted for 85.7% of those with the onset of symptom in rainy season. Delayed presentation >6 days (in 68.2% of patients) was related to age (P < 0.042), and health seeking behavior (P < 0.036). Staphylococcus aureus was the commonest causative organism. Seventy-seven percent (77%) underwent open arthrotomy. Anemia, septic shock, and joint stiffness were three top complications observed. Mortality rate was 2.3%, and cause of death was overwhelming sepsis. CONCLUSION: In our setting, pyogenic septic arthritis is predominantly a childhood health problem and children under 5 years of age are the most vulnerable. Delayed presentation, an important factor in morbidity and mortality associated with septic arthritis was common among the patients, calls for a public enlightenment program on the importance of early presentation.

Childhood pyogenic septic arthritis as seen in a teaching hospital South East Nigeria

Background: Childhood pyogenic septic arthritis and its associated musculoskeletal morbidity is an important health concern in developing countries. Its pattern of presentation that varies from and within subregions has implications on the early recognition, treatment, and outcome. The aim of this study was to determine the pattern and outcome of childhood septic arthritis in our environment. Materials and Methods: This was a retrospective study of all the children seen with pyogenic septic arthritis in Federal Teaching Hospital Abakaliki between January 2005 and December 2015. Results: Childhood septic arthritis accounted for 44 (83%) of the 53 patients seen with pyogenic septic arthritis. Female to male ratio was 1:1.75 and the mean age was 5.7 ± 0.73 years. Eight patients (18.2%) had polyarticular involvements. The right shoulder was significantly more involved than the left and the left hip more than right. Overall, there was a preponderance of onset of symptoms in the dry season. Children from the rural areas accounted for 85.7% of those with the onset of symptom in rainy season. Delayed presentation >6 days (in 68.2% of patients) was related to age (P < 0.042), and health seeking behavior (P < 0.036). Staphylococcus aureus was the commonest causative organism. Seventy-seven percent (77%) underwent open arthrotomy. Anemia, septic shock, and joint stiffness were three top complications observed. Mortality rate was 2.3%, and cause of death was overwhelming sepsis. Conclusion: In our setting, pyogenic septic arthritis is predominantly a childhood health problem and children under 5 years of age are the most vulnerable. Delayed presentation, an important factor in morbidity and mortality associated with septic arthritis was common among the patients, calls for a public enlightenment program on the importance of early presentation

Analysis of Risk Factors for Gunshot Wound Infection in a Nigerian Civilian Trauma Setting.

BACKGROUND: Survivors of firearm injury are at risk of wound infection. On average, civilian gunshot wound infection rates in developing countries are relatively high and almost on a par with infection rates in war trauma settings. Overall, there are limited data on civilian gunshot wound infection and its predisposing factors. The aim of this study was to determine the risk factors for gunshot wound infection in a civilian trauma setting of a developing nation. MATERIALS AND METHOD: This was a retrospective analysis of data on the entire patients who presented in Federal Teaching Hospital Abakaliki with firearm injury from January 2005 to December 2014. RESULTS: There were 196 patients, and wound infection was a complication in 58 (29.6 %) of them. The significant factors for high wound infection rate in univariate analysis were perforating wound (p < 0.001), high velocity injury (p < 0.001), haematocrit <30 % (p < 0.001), presence of fracture (p < 0.001), hollow viscus injury (p < 0.001) and injury to hospital arrival interval later than 6 h (p < 0.014). Anatomical site of injury correlated with infection rate (p < 0.001), highest rate (40.6 %) in lower extremity and least (9.1 %) in head and neck wounds. Multivariate logistic regression analysis identified haematocrit (p < 0.001), perforating wound (p < 0.021), presence of fracture (p < 0.043) and hollow viscus injury (p < 0.039) as independent predictors of gunshot wound infection. CONCLUSION: The independent predictors of infection identified in this study call for judicious replacement of blood loss and high priority accorded to perforating wound, fractures and hollow viscus injury in interventions aimed at reducing gunshot wound infection rate.

An analysis of risk factors associated with traumatic extremity amputation stump wound infection in a Nigerian setting.

PURPOSE: We aimed to determine the risk factors associated with traumatic extremity amputation stump wound infection in our environment. METHOD: This was a retrospective analysis of databases that included the entire patient population with traumatic extremity amputation seen in Ebonyi State University Teaching Hospital and Federal Medical Centre Abakaliki from January 2001 to December 2011. RESULT: There were 63 patients studied and stump wound infection was a complication in 38 (60 %) of them. Stump wound infection rate significantly correlated with the form of amputation, i.e., a higher rate in crushing than guillotine (sharp clear-cut) amputation (80.5 vs. 22.7 % p < 0.000); severity, i.e., a higher rate in major than minor amputation (80.6 vs. 33.3 % p < 0.000); and limb involvement, i.e., a higher rate in lower than upper extremity amputation (71.1 vs. 60.7 % p < 0.002). Haematocrit level on admission (p < 0.002), injury to hospital admission interval (p < 0.012) and injury to first surgical debridement / amputation interval (p < 0.02) were all significantly related to incidence of wound infection. Multivariate analysis identified crushing amputation as an independent risk factor (p < 0.009) for traumatic amputation stump wound infection. CONCLUSION: The only independent predictor of traumatic extremity amputation stump wound infection is a crushing form of amputation; it should be accorded a high priority in interventions aimed at reducing infection rate.

Traumatic extremity amputation in a Nigerian setting: patterns and challenges of care.

PURPOSE: We aimed to determine the epidemiological pattern and highlight challenges of managing traumatic amputation in our environment. METHOD: This was a ten-year retrospective study of all the patients with traumatic extremity amputation seen in Ebonyi State University Teaching Hospital and Federal Medical Centre Abakaliki from January 2001 to December 2010. RESULT: There were 53 patients with 58 amputations studied. There was a male to female ratio of 3:1 and the mean age was 32.67 ± 1.54 years. Amputations were more prevalent in the rainy season. Road traffic accident was the predominant causative factor and accounted for about 57% of amputations. A majority of the patients (81.4%) had no pre-hospital care and none of the amputated parts received optimum care. Three patients underwent re-attachment of amputated fingers and one was successful. Wound infection (in 56.6% of patients) was the most common complication observed. Overall mortality was 7.5% and all were due to complications of amputations. CONCLUSION: Appropriate injury prevention mechanisms based on the observed patterns are needed. Educational campaigns for prevention should be intensified during the rainy season and directed toward young men. Measures aimed at improving pre-hospital care of patients and optimum care of amputated parts is an important aspect to be considered in any developmental programme of replantation services in the sub-region.