Living with a leg amputation

Before the leg amputation

Learn about what happens leading up to a planned amputation and how you can prepare yourself.

Summary

Preparing yourself for a planned amputation

You may have already known for some time that you have an amputation ahead of you. Even though this knowledge is very hard to bear – you are not on your own in this difficult phase of your life. We want to help you prepare yourself for this step. Learn what happens when a leg is amputated, who looks after you and especially what happens afterwards.

Get in touch with experts

Get in touch with experts

Even though it’s so important, many people don’t realise that you can have influence on who will be treating you. Your care team includes everyone who looks after you during and after the amputation. The team centres around your O&P professional, who also coordinates the process. It’s important that you are treated by specialists with plenty of experience with leg amputees. We provide you with information here so you can learn all about the general treatment process and the various tasks of everyone involved. Our list of experts helps you get in contact with the right specialists, and you can use our checklist to make sure you have considered all the steps.

Reasons for amputating

The most common causes for a leg amputation

An amputation is the severing of a bone in healthy tissue. When a body part is severed in a joint, this is known as a disarticulation. An amputation is required when a diseased body part is not expected to heal and the patient’s life is at risk as a result. Causes may include circulatory disorders, infections, accidents, cancer or a congenital limb difference (dysmelia). In some of the above cases, the need for an amputation is known some time in advance. On the other hand, amputations are sometimes necessary entirely unexpectedly, for example, due to severe injuries after an accident.

Amputation due to circulatory disorders

Amputation due to circulatory disorders

The most common cause for amputations in the Western world are what are known as occlusive arterial diseases. Aside from other metabolic diseases such as diabetes, what is known as “smoker’s leg” is a very well known and widespread occlusive arterial disease. With a circulatory disorder, the supply of oxygen to the leg is no longer sufficient. If you are affected by this, you often experience pain and find walking uncomfortable. The leg or foot are colder than the rest of the body and sometimes also bluish in colour. An amputation of the lower limb is performed only if blood circulation cannot be restored by other vascular surgery procedures. With partial amputations, the goal is also to preserve the rest of the foot or leg.

Amputation due to diabetic foot syndrome

Phẫu thuật cắt cụt chân do hội chứng bàn chân tiểu đường

Hội chứng bàn chân tiểu đường là một trong những nguyên nhân phổ biến nhất dẫn đến việc cắt cụt chân hoặc bàn chân. Nhưng mặc dù ngày càng có nhiều người sống đến tuổi cao và số người mắc bệnh đái tháo đường cũng vì thế mà tăng lên, nhưng số ca cắt cụt chi đang thay đổi rất ít.
Bệnh đái tháo đường thường gây ra một số rối loạn tăng cường lẫn nhau.

  • Lượng mồ hôi giảm khiến bàn chân, bàn chân bị khô, nứt nẻ.

  • Đường lắng đọng trong các dây thần kinh khiến những người bị ảnh hưởng mất cảm giác, do đó họ không còn nhận thấy các vết nứt và vết thương.

  • Bệnh đái tháo đường làm suy yếu nghiêm trọng việc chữa lành vết thương.

  • Khi vết loét bị tác động, vết thương sẽ phát triển lớn hơn. Mô bị viêm và chết đi.

Ngoài ra còn có nguy cơ khiến bàn chân và chân bị viêm nhanh hơn do tuần hoàn máu bị gián đoạn do bệnh tiểu đường và các tế bào chết đi.

Amputation after an accident

Phẫu thuật cắt cụt chân do tai nạn

Tần suất cắt cụt chi sau tai nạn - ví dụ như tai nạn lao động và tai nạn giao thông vẫn tăng cao tại các nước đang phát triển như Việt Nam.

Amputation due to tumours

Amputation due to tumours

Amputations due to cancer are relatively rare. In many cases, however, there are tumours close to the knee or in the area of the hip. Around half of all amputations in the area of the hip and pelvis are due to tumours. The goal of an amputation in such cases is to save the patient’s life by preventing the spread of cancer cells that would affect other parts of the body.

Amputation after an infection

Amputation after an infection

Amputations due to infections have become extremely rare since Louis Pasteur described the effect of antibiotics in 1877. The high antiseptic standards in medical treatment and tetanus shots are another reason for the decrease. Nevertheless, you need to be vigilant even with the tiniest injury. Signs of inflammation include reddening, swelling, fever and pain in a wound.

Also check whether your tetanus shot is still up to date. The Robert Koch Institute recommends a booster every ten years, or sometimes sooner if wounds occur. Please contact your doctor in any case.

Amputation levels

The appropriate amputation level is established

The term amputation level describes the place where a body part is amputated. It is established by the doctor before the operation and is based on the reason for amputating.

If the surgery is planned, your O&P professional can be included in the consultations beforehand. The O&P professional can provide advice regarding the most suitable amputation level for the subsequent fitting with a prosthesis.

This is because the amputation level is one of the factors in determining the right prosthesis. It establishes what parts and joints of your leg have to be replaced by a prosthesis.

Foot amputation

Foot amputation

There are more than twelve different amputation levels in the area of the foot. They range from a toe amputation to a midfoot amputation to amputations in the area of the tarsus.

Silicone prostheses can be used for a prosthetic fitting.

Transtibial amputation (lower leg amputation)

Transtibial amputation (lower leg amputation)

With a transtibial amputation, the tibia and fibula are severed.

A prosthetic foot, adapters and connecting elements to the prosthetic socket are needed for the prosthetic fitting.

Knee disarticulation

Knee disarticulation

A knee disarticulation is when the knee joint is cut, severing the lower leg. The entire thigh is retained.

A prosthetic foot, knee joint, adapters and connecting elements to the prosthetic socket are needed for the prosthetic fitting.

Transfemoral amputation (above-knee amputation)

Transfemoral amputation (above-knee amputation)

With a transfemoral amputation, the femur is severed.

A prosthetic foot, knee joint, adapters and connecting elements to the prosthetic socket are needed for the prosthetic fitting.

Hip disarticulation

Hip disarticulation

During a hip disarticulation, the amputation is performed in the area of the hip joint. With this amputation, the pelvis will later control the prosthesis.

A prosthetic foot, knee joint, hip joint, adapters and connecting elements to the prosthetic socket are needed for the prosthetic fitting.

Hemipelvectomy

Hemipelvectomy

In a hemipelvectomy, the entire leg and parts of the pelvis up to the sacrum are amputated. With this amputation, the pelvis will later control the prosthesis.

A prosthetic foot, knee joint, hip joint, adapters and connecting elements to the prosthetic socket are needed for the prosthetic fitting.

Treatment team

These experts are there for you and look after your treatment

A team of experts from various disciplines handles your treatment before and after an amputation. We have listed the members of this team here and described the role each of them plays in your treatment.

The O&P professional plays a pivotal role within this team. We advise you to seek contact with them even before the amputation if possible. Our list of experts can help you find someone who already has a great deal of experience in working with leg amputees and is therefore able to provide you with good advice.

Bác sĩ phẫu thuật

Surgeon

The surgeon advises you before the amputation and performs the operation. Ideally, the surgeon will work with your O&P professional to coordinate the course of the operation in advance. For example, the surgeon and O&P professional can discuss the shape of your residual limb ahead of time, which makes the subsequent fitting of your prosthetic socket easier. After the amputation, the surgeon monitors your recovery and prescribes rehabilitation.

General practitioner and specialist

General practitioner and specialist

In most cases, your general practitioner and specialist have looked after you even before the amputation and are familiar with the course of your illness. They are available when you need prescriptions for new prosthetic components or additional rehabilitation measures.

Social education workers and social services

Social education workers and social services

A social education worker or other social services employee usually looks after you while you are still in hospital. Their task is to help you during your return to everyday life. This includes topics such as your home, education, work, family, income and social networks. They tell you what services are available and how you can access them. Examples of services include medical, special and social education measures or assistance for participation in social life.

Inpatient nursing staff

Inpatient nursing staff

After the amputation, nursing staff in the hospital and specialised wound managers look after wound healing and the correct positioning and compression of your residual limb. Ideally, this is coordinated with the doctors, O&P professional and therapist.

Physiotherapists and occupational therapists

Physiotherapists and occupational therapists

Physiotherapists and occupational therapists assist you in the hospital, during rehabilitation and in everyday life. Their task is to get you moving, to strengthen and stretch your musculature, and to help you learn and make further improvements in walking and coping with activities of daily living. Therapists also do compression therapy in the hospital.

O&P professional

O&P professional

Your O&P professional plays a central role since they fit you with a suitable prosthesis and can offer advice if you have questions. Leading up to an amputation, the O&P professional can discuss with the surgeon what your residual limb should look like if possible. They can recommend experienced therapists or orthopaedic shoemakers and put you in contact with other amputees. You can also ask them about things like a contact for home conversions or vehicle alterations.

When fitting you with a prosthesis, the O&P professional clarifies your needs and preferences and discusses the various treatment options with you. Based on this, they select the appropriate prosthetic components and fabricate your prosthesis with a customised prosthetic socket. They will already examine your residual limb shortly after the amputation and determine whether an interim prosthesis is an option for you.

Your O&P professional is available to you for all questions related to your prosthesis.

Orthopaedic shoemaker

Orthopaedic shoemaker

In addition to the prosthesis, you may need appropriate shoes for your sound foot. This may be the case if you have a circulatory disorder, for example. Orthopaedic shoes may also be an option for you with a partial foot amputation if you do not wear a partial foot prosthesis. Ask your O&P professional for contact information.

Outpatient nursing staff

Outpatient nursing staff

Depending on your family situation, outpatient nurses can assist you with using the prosthesis and also take charge of compression and mobilisation in everyday life.

Relatives and social environment

Relatives and social environment

Your relatives also contribute to your rehabilitation and will try to support you to the best of their ability in daily life. The question of what concrete role they can play depends on your personal situation. It’s possible for a relative to assist you with the daily use of the prosthesis and help you with everyday tasks.

Thông tin liên hệ

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