Traumatic amputation, the accidental severing of a portion or all of a body part,
is a significant life-threatening and life-altering event. Amputation may be complete,
where the limb or appendage is completely severed from the body, or partial, where
some soft tissue remains at the site.
A traumatic injury, including car accidents and severe burns, can destroy blood vessels
and cause tissue death. In some cases, if an amputation is not performed, an infection
can spread through the body and become fatal. While 22% of amputations are trauma
related, 68.6% of those amputations are of the upper limbs. Also, males have a much
higher risk for a trauma related injury.
Upper limb amputations account for the largest percentage of traumatic amputations.
Males are at considerably higher risk for trauma-related amputations. In both males
and females, the risk of traumatic amputation increases steadily with age, culminating
in the highest risk for those age 85 or older.
In traumatic amputation, the level of amputation is determined by the level of injury,
or which parts of the body were affected by the injury. Surgeons adhere to the maxim
that preservation of limb length and joint function is of utmost importance in order
for the victim to fit and use a prosthesis. The energy required to use a limb increases
as the limb becomes shorter.
Upper Limb Amputations
Amputation of individual digits- the thumb is the most commonly amputated digit,
and loss of this digit will impair the victimís ability to grasp objects. When the
victim loses other digits, grasping ability is affected but they will retain some
Multiple digit amputation- when more than one digits are lost, surgeons may be able
to construct muscles to aid grasping ability.
Metacarpal amputation- this type of amputation involves loss of the entire hand but
the wrist is still intact; the victim will have no ability to grasp.
Wrist disarticulation- involves the loss of the hand, but at the level of the wrist
joint. Technology now exists to have plastic sockets made to serve as wrists.
? Forearm (transradial) amputation- this type of amputation may be classified by
the length of the remaining stump. As stump length decreases, so does the victimís
pronation ability, or the ability to rotate the forearm.
? Elbow disarticulation- this type of amputation involves the removal of the entire
forearm at the elbow. In this type of amputation, the victim will retain the ability
to hold weight.
? Above-elbow (transhumeral) amputation- involves amputation anywhere above the elbow
and below the shoulder. If some length is left to the humerus, a prosthesis may still
? Shoulder disarticulation- in this type of amputation, the shoulder blade remains.
The collarbone may or may not be removed.
? Forequarter amputation- includes removal of the shoulder blade and collarbone.
Surgeons would ideally leave some length of bone for prosthetic use.
Lower Limb Amputations
? Foot amputations- can include any portions of the foot, such as toes and mid-tarsal
amputations. The great toe is commonly affected, and may affect balance and walking.
? Ankle disarticulation (Syme amputation) - involves amputation of the entire ankle.
In this type of amputation, the victim can mobilize without prosthesis.
? Below-knee (transtibial) amputation- amputation occurs above the ankle but below
the knee. Victims retain the use of the knee, but may have difficulty putting weight
on the stump.
? Knee-bearing amputation- amputation involves the complete removal of the lower
leg. It may be difficult to create a prosthesis in this type of injury.
? Above-knee (transfemoral) amputation- involves amputation at the level of the thigh.
The victim will be able to sit with this type of amputation.
? Hip disarticulation- involves removing the entire leg bone. Surgeons will try to
preserve some length in the femur to allow the use of a prosthesis.
As stated, the goal of surgeons is to leave enough bone and preserve the joint where
possible to allow the victim to be able to use a prosthesis.
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