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What is an Amputation?

Amputation is an acquired condition that results in the loss of a limb, usually from injury, disease, or surgery. Congenital (present at birth) limb deficiency occurs when an infant is born without part or all of a limb.

What causes the need for amputations?

The causes for limb removal may include any of the following:

  1. Diseases - such as blood vessel disease (called peripheral vascular disease or PVD), diabetes, blood clots, or osteomyelitis (an infection in the bones).
  2. Injuries - especially of the arms. Seventy-five percent of upper extremity dismemberment are related to trauma.
  3. Surgery - to remove tumors from bones and muscles.

Amputation & Diabetes

People with diabetes are prone to many foot problems, often because of two complications of diabetes: nerve damage (neuropathy) and poor blood circulation. Neuropathy causes loss of feeling in your feet, taking away your ability to feel pain and discomfort, so you may not detect an injury or irritation. Poor circulation in your feet reduces your ability to heal, making it hard for even a tiny cut to resist infection.

Diabetic foot or leg separation often begins with a seemingly minor injury. The following scenario is typical:

1. Poorly fitting shoes cause a blister.
2. Unnoticed and untreated, the blister opens.
3. A common bacterial, fungal or other microbial infection enters the sore.
4. Poor circulation limits the body’s ability to fight the infection.
5. The ulcer deepens and damages muscle tissue.
6. The infection spreads to bone (osteomyelitis).
7. The infection kills tissues (gangrene).
8. Antibiotics and wound care fail to cure the infection.
9. Severing the limb becomes the only way to keep gangrene from spreading.

One amputation is a risk factor for a second foot or leg removal. Prevention, then remains a major concern for amputees as well as potential amputees, such as persons with diabetes who have a foot deformity, nerve damage or poor circulation.

According to the health institutes, ill-fitting footwear and failure to treat minor foot injuries early are the most common and avoidable causes of diabetic foot or leg dismembering. It is essential for people with diabetes to:

  • Wear proper shoes and socks
  • Clean and inspect the feet daily
  • Get prompt medical attention for any foot problems
  • Have a comprehensive foot exam at least once a year by a physician

In addition, quitting of smoking habits can benefit the blood vessels and reduce the risk of foot problems that may lead to severing of limbs.

When is Amputation Necessary?

The goals of treatment of diabetic foot problems are not only to save the life and limb, but also to get the patient healed and moving about as soon as possible.

If vascular surgery cannot improve blood flow and podiatric surgery cannot restore function, removal of limbs may be the only solution that gets the patient walking again.

Amputation may involve one or two toes, part of the foot, or part of the leg. It is selected on the basis of the patient's condition and level of predicted healing. A return to normal life is especially possible today because of advances in prosthetics.

Risks and side effects


Amputations also carry their own unique risks and side effects. These include:

  • Phantom limb pain

  • Stump pain and swelling (edema)

  • Joint contractures, especially flexion (bending) of the knee

  • Opening and infection of the dislodge site after surgery

  • The need for further removal because of improper healing

  • Unsteady gait (way of walking) that increases risk of falls

Radial Nerve Dysfunction

Is also known as “Crutch palsy” which is caused by improper use of crutches where one will experience temporary or permanent loss of sensation or muscle control from the pressure on the radial nerve. The radial nerve passes under the axillary area superficially. Pressure, often caused by mismatching of the height of the user and the crutch, which can lead to paralysis of the elbow and wrist extensors.

Complications of Scoliosis

Progressive scoliosis that is untreated can result in significant deformity and back pain, cardiopulmonary compromise if in the thoracic area with a curve greater than 65 degrees and debilitating back pain if in the lumbar area.





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