Amputation

Question 1

What are the different types of amputations of the lower limb?

Answer 1

Partial foot amputation: amputation of one or more toes

Ankle disarticulation: amputation of the foot at the ankle

Below knee amputation: transtibial amputations below the knee.

Through the knee (rarely done)

Above the knee.

Question 2

Outline the principles of lower limb amputation?

Answer 2

Aim to do it as low as possible as will require the patient to use less energy to walk with a prosthetic limb.

Considerably more energy is used in above knee amputations.

Decision regarding where to amputate is based on how much tissue is viable.

Question 3

What are the indications for amputation?

Answer 3

Non viable tissue due to acute limb ischaemia.
Wet* gangrene (toes).
Severe osteomyelitis.
Osteosarcoma.

*Dry gangrene will often auto-amputate.

Question 4

Which teams are involved in rehabilitation of patients following an amputation?

Answer 4

Medics (vascular + rehabilitation)
Physiotherapists
Occupational therapist
Nurses
Rehabilitation engineers