Limb amputation is a dreadful experience for the one who undergoes such operations although it is most likely to save the life of that person. It is a surgery performed at various levels depending on the indications for its application. Even though many would recover from such surgeries without any major complications, it is a major surgery which would require post operative follow-up for a prolonged period till such time the person is able to cope up with such a limb loss and develops skills necessary to undertake activities of daily living to a satisfactory level.
What are the indications for performing lower limb amputations?
Traumatic injury may be one of the commonest reasons for lower limb amputations although diabetic foot has risen to become a significant cause for lower limb amputations in patients with chronic non healing diabetic ulcers. In certain parts of the world, many lower limb amputations are being performed following land mine explosions although such mines are banned through international treaties as a war item. Apart from these, circulatory failure, infections…etc can also lead to possible amputations of the lower limb. Although saving life is the priority in many instances, relieving a patient from agonizing pain and suffering would also be a major concern in deciding to perform an amputation.
What are the types of lower limb amputations?
A commonly performed lower limb amputation is the toe amputations either due to diabetic ulcers or else due to gangrenous tissues following poor circulation. But, it is possible for such amputations to affect the day to day activities in relation to walking and maintaining balance although it will not be as disabling as it would be in some of the other types of lower limb amputations.
When considering the next level of amputation, ankle disarticulation or ‘syme’ procedure needs to be highlighted as it will remove the foot with the skin flaps covering the remaining lower end of the tibia and fibula bones.
The next level will be an amputation below the knee but above the ankle and therefore it is known as below knee amputations or transtibial amputations.
Knee bearing amputation is the amputation at the level of the knee and although it preserve the functioning of the knee to a certain extent it gives rise to problems of developing prosthesis in the long term follow-up of such patients.
When considering the next level of amputation, above knee amputations should be highlighted and lastly, the entire leg can be removed in a hip disarticulation surgery.
Although there are many different levels of lower limb amputations, it is obvious that, the surgeons will first look at saving the patients life and the best possible outcome following an amputation. Thus, expected level of mobility will be considered in any patient undergoing a limb amputation although it may not be the main consideration to undertake such a surgical decision.
