A planned lower limb amputation is a significant medical process that requires physical and psychological preparation before surgery. Understanding in advance what happens before the operation, who takes part in the process and what to expect during recovery after surgery can help the person take part in the process more consciously. The information below has been compiled for general information purposes, and the specialist physician's assessment is always the basis.
Common causes of amputation
Amputation is a surgical procedure used when an injured or diseased part of the body is not expected to heal and poses a risk to the person's health. The main causes are:
- Circulatory disorders: Insufficient blood flow due to narrowing of the arteries (occlusive arterial disease) reduces the oxygen reaching the tissues. Pain, discomfort when walking, coldness and color change in the affected area may be seen. Amputation is only considered when circulation cannot be corrected by other vascular surgery methods.
- Diabetic foot syndrome: High blood sugar can damage nerves and blood vessels. With nerve damage (neuropathy), the sensation of pain may decrease; this can lead to cuts and ulcers going unnoticed, infections and delayed wound healing.
- Accidents: Amputation after work and traffic accidents has decreased markedly thanks to occupational safety standards and developments in surgery and intensive care.
- Tumors: In some tumors around the knee or close to the hip region, amputation may be necessary to prevent the disease from spreading. This is relatively rare.
- Infections: Thanks to antibiotics, sterilization standards and vaccines, infection-related amputations have become quite rare. Nevertheless, signs of inflammation, redness, swelling, fever and pain in wounds should be watched for.
Amputation levels
The "amputation level" defines the point at which the body is amputated and is determined by the surgeon before the operation according to the cause. The main levels in the lower limb are:
- Foot amputation: Includes more than twelve different levels, from the toes to the midfoot.
- Below-knee (transtibial) amputation: The incision passes through the tibia and fibula bones of the lower leg.
- Knee disarticulation: The knee is separated and the lower leg is removed; the thigh bone is preserved.
- Above-knee (transfemoral) amputation: The incision passes through the thigh bone (femur).
- Hip disarticulation and hemipelvectomy: The amputation is performed in the hip joint region or in an area extending to the pelvis; in these cases, the pelvis takes over control of the prosthesis.
In planned operations, the prosthetic specialist may take part in earlier consultations. The prosthetic components to be used are determined in line with the specialist physician's prescription and medical report, according to the amputation level, the person's lifestyle and daily activities. Depending on the level, a custom-made socket, a suitable prosthetic foot and, where necessary, a prosthetic knee or hip joint together with connecting adapters may be planned.
The treatment team
Lower limb amputation requires specialists from different disciplines to work together:
- Surgeon: Carries out an assessment of the amputation level before the operation; afterwards, follows recovery and rehabilitation.
- Nursing staff: Monitor wound healing and ensure correct positioning and compression of the residual extremity (residual limb).
- Physiotherapist and occupational therapist: Provide support with movement, muscle strengthening and stretching, gait training and adaptation to daily life.
- Prosthetic specialist: Fits the appropriate prosthesis and provides guidance throughout the process; where possible, may also take part in the assessment before surgery.
- Family and social circle: Contribute to rehabilitation by providing support with daily tasks and the daily use of the prosthesis.
The preparation process
When preparing for amputation, it is helpful for the person to obtain information about the type of amputation they will undergo, the general course of living with amputation and its possible effects on their daily life, and the sources of support available to them. Home adjustments and, where necessary, vehicle modifications can help the process be managed more comfortably. All applications are planned in line with the specialist physician's prescription and medical report.
This content is for informational purposes only; for diagnosis and treatment, you should consult your physician.