Amputation is the surgical removal of all or part of a limb. Normally only performed to save someone’s life, amputation can be necessary in cases of severe injury, infection, trauma or complications related to an underlying health condition like cancer or diabetes.
Specialists at The University of Kansas Health System offer comprehensive care before, during and after amputation surgery. Together, as a multidisciplinary team, they work closely with you from surgery through recovery, rehabilitation, prostheses fitting and long-term management of your condition.
What is an amputation?
Amputation is a type of surgery that involves removing all of a limb or extremity (major amputation) or a portion of a limb or extremity (minor amputation). In some cases, it is better to try a limited amputation if there is a chance of healing. If healing doesn't occur or limited amputation is not an option, complete amputation may be recommended.
Once an amputation stump is created, it is a potentially vulnerable area that requires lifelong care and attention. Part of recovery after amputation includes rehabilitation as well as being fitted for and learning how to use a prosthetic limb.
Who can have an amputation?
How does an amputation work?
Amputation is performed to stop a serious disease or infection from spreading to the rest of the body by removing the affected limb. Sometimes, your doctor may perform amputation to remove a limb that is so injured by trauma that the wound has become life-threatening. Amputation is always a last resort, and your surgeon will not advise you to have the procedure unless it is absolutely necessary.
In cases where a limb is affected by a congenital condition (defect present from birth), doctors may perform amputation because living with a prosthetic limb can improve your quality of life.
Benefits and risks of an amputation
There are significant risks attached to amputation if you are older and have hardening of the arteries. However, if you are younger, healthy and have an amputation because of an injury or a tumor, the risks are much less.
Amputation of a limb or limbs affects people in different ways. It is very personal, and for many people can feel like bereavement. The emotional loss is similar to losing a family member and it takes time to adapt. Physically, your body is permanently altered, and this affects all areas of your life. How much your amputation affects your life also depends on the extent of your physical recovery.
What happens during an amputation?
The precise steps your doctor takes during amputation surgery will vary depending on the type of amputation that’s being performed. Major amputation can be performed above or below a major joint, such as a knee or elbow. Minor amputation removes smaller areas, such as a toe or part of the foot. Your doctor will go over all the details of your specific procedure ahead of time.
Amputation surgery involves removing as much of the diseased, infected or injured area as required for the best possible outcome. The most important aspect of a successful amputation is ensuring an adequate blood supply to the affected area during recovery to allow for complete healing.
Generally, the more limited the amputation the lower the risks and the better the chances of walking. There are virtually no activities that a person with an amputation cannot perform with the right help, training and equipment. However, the most important rehabilitation objective for the majority of older patients with a lower limb amputation is to walk again. It is important to remember that rehabilitation from an amputation in an older person is much more difficult than in a young person. Regaining the ability to walk is a major achievement.
Whether you will be able to walk following an amputation has been studied by looking at factors present before surgery. Poor preoperative mobility, over age 70, dementia and severe kidney disease and heart disease are factors that make it unlikely that walking is possible after their amputation.
After a leg amputation, the majority of people need a wheelchair. Sometimes using a wheelchair may be the best way to remain mobile. If you are older or have had other serious illnesses such as a heart attack or stroke, then it can be better not to be fitted with an artificial leg.
Below-the-knee amputation offers much better chances of successfully walking after surgery. Not everyone is suited for this procedure, and many people need to have an above-the-knee amputation. This may be because the blood supply to the lower leg is too poor and a below-the-knee amputation would not heal properly. If the knee cannot straighten out properly before the surgery, it will be impossible to walk with an artificial leg after the operation. In these circumstances it may be better to have an above-the-knee amputation.
Initially, there will be a period of recovery after amputation. Once recovery from the surgery takes place, physiotherapists and occupational therapists will concentrate on enabling you to manage independently. This requires learning new skills, such as moving from a wheelchair to the bed and back again and starting to use an artificial limb. There will be various exercises to strengthen your body and maintain flexibility and movement in the amputated limb.
A permanent made-to-measure artificial limb (prosthetic) will be made for you when you are ready. This can only be done when your postoperative swelling is getting better and may take more than one attempt before the right fit is achieved.
Phantom limb is the sensation of still being able to feel the amputated limb. Most amputees experience this sensation, although the intensity varies from person to person. In many cases, pain is also experienced in the amputated limb, a phenomenon known as phantom limb pain. Phantom limb pain is usually fairly mild and self-limiting, although a nuisance. In a few instances, phantom limb pain can be serious and difficult to treat.