Principles of Amputation

Levels of Amputation

Amputation is a surgical procedure that involves the removal of a limb or part of a limb. The decision regarding the level of amputation is crucial for optimizing functionality, prosthetic fitting, and the patient’s overall quality of life.

Major Levels of Amputation

Upper Limb Amputation

• Forequarter Amputation: Removal of the entire arm including the scapula and clavicle.
• Shoulder Disarticulation: Amputation through the shoulder joint.
• Above-Elbow (Transhumeral) Amputation: Amputation of the upper arm above the elbow joint.
• Elbow Disarticulation: Amputation through the elbow joint.
• Below-Elbow (Transradial) Amputation: Amputation of the forearm below the elbow.
• Wrist Disarticulation: Amputation at the wrist joint.
• Partial Hand Amputation: Removal of part of the hand or fingers.

Lower Limb Amputation

• Hip Disarticulation: Removal of the entire lower limb at the hip joint.
• Above-Knee (Transfemoral) Amputation: Amputation of the thigh above the knee joint.
• Knee Disarticulation: Amputation through the knee joint.
• Below-Knee (Transtibial) Amputation: Amputation of the leg below the knee.
• Ankle Disarticulation (Syme’s Amputation): Removal of the foot at the ankle joint.
• Partial Foot Amputation: Includes Chopart, Lisfranc, and toe amputations.

Factors Influencing Level of Amputation

• Extent of tissue damage due to trauma or disease.
• Presence of vascular complications, especially in diabetic patients.
• Potential for prosthetic rehabilitation and mobility.
• Cosmetic and functional considerations.

Conclusion

Amputation levels are carefully selected based on patient-specific factors, underlying pathology, and future rehabilitation goals. A multidisciplinary approach involving surgeons, prosthetists, and therapists ensures the best possible outcome.