AMPUTATION
PREPARED BY: Ms. STELLA
CHEPTOO
Dept.’ Orthopaedics & Trauma
Med.
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An overview of amputation, including definitions, indications, types, principles, complications, and bandaging. It also covers the aims and types of prosthetic stages. that amputation is the removal of a part or total portion of a body extremity by prolonged construction or intentional surgical construction for the purpose of removing diseased tissue or relieving pain. The document also lists the indications for amputation, such as trauma, circulatory disorders, malignant tumors, nerve injuries, and congenital absence of limbs or malformation. useful for medical students and professionals.
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2025/2026
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AMPUTATION
PREPARED BY: Ms. STELLA
CHEPTOO
Dept.’ Orthopaedics & Trauma
Med.
Definition of terms ▶ Amputation: Removal of a part or total portion of a body extremity by prolonged construction or intentional surgical construction for the purpose to remove diseased tissue or relieve pain. ▶ Disarticulation: Removal of limb through a joint. ▶ Stump: A residual limb that is left beyond a healthy joint.
Illustratio n
Illustratio n
Indications for amputation ▶ Trauma: severe limb injuries beyond repair. ▶ Circulatory disorders: diabetic foot infection or gangrene.(most common reason for non- traumatic amputation.) ▶ Malignant tumors. ▶ Nerve injuries and infection. ▶ Congenital absence of limbs or malformation.
Incidenc e ▶Lower limbs: 85% ▶Upper limbs: 15% ▶Amputation of lower limbs are more common than upper limbs.
Types of amputation ▶ Closed amputation: done as an elective procedure. After amputation the soft tissues are closed primarily over the bony stump. i.e. above knee, below knee. ▶ Open amputation: done as an emergency procedure, e.g. life threatening infections. After amputation, the wound is left open and not closed.
Cont.’ open amputation ▶2 types depending on/upon the skin flaps:
- Open amputation with inverted skin flap.
- Circular open amputation.
Cont.’ principles of closed amputation ▶ Nerves: cut proximally and allowed to retract. Large nerves are ligated before division. ▶ Blood vessels: doubly ligated and cut. The tourniquet is then released and hemostasis is completed. ▶ Bone: section above level of muscle section. ▶ Drains: removed after 48-72 hrs.
Cont.’ principles of closed amputation ▶ Compression dressing: either a elastic or a rigid plaster dressing fitting immediately. ▶ Absolute bed rest with limb elevation: this is acceptable for the conventional prosthesis with adequate vascularity. ▶ Limb fitted: conventional prosthesis is fitted a minimum of 8-12 weeks after surgery.
Cont.’ complications
▶ Necrosis.
▶Stump pain.
▶ Phantom pain.
▶ Neuromas.
▶Bone overgrowth.
▶Stump edema.
▶ Infection.
Principle consideration to amputate ▶Preserve life. ▶Improve general health. ▶Restore function. ▶Reduce pain.
Post operative training: Aims
▶ To prevent post operative training.
▶ To prevent deformities.
▶ To control stump edema.
▶ To maintain general mobility.
▶ To improve balance and transfer.
▶ To re-educate walking.
▶ To restore functional independence.
Principle of bandaging of stamp ▶ Pressure of bandage should be:
- Moderately firm.
- Evenly distributed.
- Decreasing proximally.
- Extra pressure over the corners- conical shape. Pattern of bandage: diagonal, oblique or spiral. Not circular.