amputation

Amputation is the surgical removal of a limb or part of a limb, often resulting from trauma or disease. The procedure leaves a residual limb, or stump, that may be fitted with a prosthesis to restore function. Indications include severe or unreconstructible trauma, infection such as osteomyelitis, malignant tumors, critical limb ischemia or diabetes-related vascular disease, congenital limb deficiency, frostbite, or severe burns. Amputations are classified by the level of removal, for example transtibial (below-knee), transfemoral (above-knee), transradial (below-elbow), and transhumeral (above-elbow) amputation, with partial hand or finger amputations at the distal end.

During surgery, the goal is to remove diseased or nonviable tissue while preserving as much function as possible, ensure control of blood vessels, and create a well-shaped stump for prosthetic fitting. Nerve management is important to reduce postoperative pain and neuromas; techniques such as myodesis or myoplasty may be used. Postoperative care emphasizes wound healing, edema control, pain management, infection prevention, and early mobilization where feasible.

Rehabilitation includes physical therapy, gait and balance training, and prosthetic fitting and adjustment. Modern prostheses range from body-powered or electrical myoelectric devices to advanced systems using targeted muscle reinnervation. Rehabilitation also addresses phantom limb sensations and pain through medications, desensitization, mirror therapy, and neuromodulation when needed. Complications can include infection, wound separation, edema, contractures, neuroma, phantom limb pain, and prosthesis-related skin problems.

Outcomes depend on the underlying condition, residual limb length, comorbidity, and access to prosthetic care and rehabilitation. Amputation has a long history, with advances in anesthesia, infection control, and prosthetic technology improving function and quality of life for many patients.