Clinical Presentation, Risk Factors, and Clinical Outcomes of Patients Who Underwent Major Upper-Limb Amputation for Nontraumatic Indications: A Retrospective Study.

Background Major upper-limb amputations are performed for various nontraumatic causes such as limb ischemia, malignancy, and infections. These procedures have significant psychosocial and functional impacts on patients, often leading to long-term disability and reduced quality of life. Understanding the interplay between the risk factors and disease progression is essential for improving preventive and therapeutic strategies. Limited data exist correlating clinical profile and surgical outcomes in nontraumatic major upper-limb amputations. This study aims to evaluate these factors in patients undergoing nontraumatic major upper-limb amputation at a tertiary care center. This study descriptively analyzes the demographic details, clinical presentation, risk factors, and surgical outcomes of patients undergoing major upper-limb amputation for nontraumatic indications. Methodology A retrospective observational study was conducted over a two-year period (August 2023 to August 2025) in the Department of General Surgery at a tertiary care center. In total, 23 patients who underwent major upper-limb amputation for nontraumatic causes were included. Data were collected from hospital records with respect to demographic details, comorbidities, Doppler and CT angiography findings, indications and level of amputation, and postoperative outcomes, including duration of hospital stay, revision amputation, surgical site infection, intensive care unit admission, readmission, and mortality. Results Among the 23 patients, 78.9% were middle-aged, and 69.6% were male. The left upper limb was involved in 73.9% of cases. Diabetes mellitus was present in 60.9% of patients, hypertension in 39.1%, and 65.2% were smokers. Anemia was observed in 69.5%, and hypoalbuminemia in 39%. Brachial artery involvement was noted in 30% of cases. Limb ischemia was the most common indication (78%), followed by necrotizing fasciitis (17.4%). Above-elbow amputation was performed in 91.3% of patients. Revision amputation was required in 8.6% of cases. Hospital readmission occurred in 4.3%, and one (4.3%) case of mortality was recorded. The mean hospital stay was 8.7 days. Conclusions Vascular insufficiency was noted to be the leading cause of nontraumatic major upper-limb amputation. While limited by a small sample size, these findings provide a descriptive profile with respect to nontraumatic major upper-limb amputations. Early diagnosis and aggressive management of vascular and infectious etiologies may improve limb salvage rates and reduce morbidity and mortality.