A cross-sectional study on the prevalence and patterns of amputations following orthopedic-related trauma of the extremities in Northern Tanzania (January 2023 to December 2024)

Background: Limb amputation significantly affects mobility and quality of life, with causes varying globally. In high-income countries, peripheral vascular disease and diabetes are the leading causes, while trauma dominates in low- and middle-income countries (LMICs). Trauma-related amputations, often due to motor traffic crashes (MTCs), are increasing in LMICs due to economic growth and rising road density. Amputation is typically a last resort when limb preservation is unfeasible, but limited rehabilitative services in LMICs hinder functional recovery. Globally, traumatic amputations are rising, with men and young adults most affected. Objective: To determine the prevalence and patterns of amputations following orthopedic-related extremity traumas from January 2023 to December 2024 in Northern Tanzania. Methods: This hospital-based cross-sectional study was conducted among orthopedic trauma patients admitted between January 2023 and December 2024 in Northern Tanzania. Adult patients (≥18 years) with extremity injuries were consecutively sampled from admission records and verified using the electronic health management system. Data on demographics, clinical characteristics, and amputation-related factors were extracted using a structured tool. Patients with primary amputations performed elsewhere were excluded. Data were cleaned, categorized, and analyzed using SPSS version 25. Descriptive statistics summarized variables, and logistic regression was used to assess associations between amputation and explanatory factors, with significance set at P < 0.05. Results: The prevalence of limb amputation among orthopedic trauma patients was 6.2%. Most amputations involved the lower limb (67.9%), and MTCs were the leading cause (57.1%). Among the 911 patients analyzed (median age 43 years, 71.2% male), fractures were the most common injury type and predominantly affected the lower limbs. Severe open fractures especially Gustilo type IIIA and IIIB as well as injuries to the digits and foot were the strongest predictors of amputation. Trans-femoral and digit-level amputations were the most frequently performed procedures. Conclusion: The overall prevalence of amputation was 6.2% in the 2-year study period. MTCs, severe open fractures, and young age are major risk factors for limb amputation. Bilateral injuries and lower limb trauma significantly increase amputation likelihood. Timely surgical intervention, especially in open fractures, is crucial to reducing limb loss.