Leg or foot amputation

  • Definition
    • Leg or foot amputation is the removal of a leg, foot or toes from the body. These body parts are called extremities. Amputations are done either by surgery or they occur by accident or trauma to the body.

  • Alternative Names
    • Amputation - foot; Amputation - leg; Trans-metatarsal amputation; Below knee amputation; BK amputation; Above knee amputation; AK amputation; Trans-femoral amputation; Trans-tibial amputation

  • Why the Procedure Is Performed
    • Reasons for having an amputation of a lower limb are:

      • Severe trauma to the limb caused by an accident
      • Poor blood flow to the limb
      • Infections that do not go away or become worse and cannot be controlled or healed
      • Tumors of the lower limb
      • Severe burns or severe frostbite
      • Wounds that do not heal
      • Loss of function to the limb
  • Risks
    • Risks of any surgery are:

      • Blood clots in the legs that may travel to the lungs
      • Breathing problems
      • Bleeding

      Risks of this surgery are:

      • A feeling that the limb is still there. This is called phantom sensation. Sometimes this feeling can be painful. This is called phantom pain.
      • The joint closest to the part that is amputated loses its range of motion, making it hard to move. This is called joint contracture.
      • Infection of the skin or bone.
      • The amputation wound does not heal properly.
  • Before the Procedure
    • When your amputation is planned, you will be asked to do certain things to prepare for it. Tell your health care provider:

      • What medicines you are taking, even medicines, supplements, or herbs you bought without a prescription
      • If you have been drinking a lot of alcohol

      During the days before your surgery, you may be asked to stop taking aspirin, ibuprofen (such as Advil or Motrin), warfarin (Coumadin), and any other medicines that make it hard for your blood to clot.

      Ask your provider which medicines you should still take on the day of your surgery. If you smoke, stop.

      If you have diabetes, follow your diet and take your medicines as usual until the day of surgery.

      On the day of the surgery, you will likely be asked not to drink or eat anything for 8 to 12 hours before your surgery.

      Take any medicines you have been told to take with a small sip of water. If you have diabetes, follow the directions your doctor gave you.

      Prepare your home before surgery:

      • Plan for what help you will need when you come home from the hospital.
      • Arrange for a family member, friend, or neighbor to help you. Or ask your provider for help planning for a home health aide to come into your home.
      • Ensure that your bathroom and the rest of your house are safe for you to move around in. For example, remove tripping hazards such as throw rugs.
      • Ensure that you will be able to get in and out of your home safely.
  • After the Procedure
    • The end of your leg (residual limb) will have a dressing and bandage that will remain on for 3 or more days. You may have pain for the first few days. You will be able to take pain medicine as you need them.

      You may have a tube that drains fluid from the wound. This will be taken out after a few days.

      Before leaving the hospital, you will begin learning how to:

      • Use a wheelchair or a walker
      • Stretch your muscles to make them stronger
      • Strengthen your arms and legs
      • Begin walking with a walking aid and parallel bars
      • Start moving around the bed and into the chair in your hospital room
      • Keep your joints mobile
      • Sit or lie in different positions to keep your joints from becoming stiff
      • Control swelling in the area around your amputation
      • Properly put weight on your residual limb. You will be told how much weight to put on your residual limb. You may not be allowed to put weight on your residual limb until it is fully healed.

      Fitting for prosthesis, a manmade part to replace your limb, may occur when your wound is mostly healed and the surrounding area is no longer tender to the touch.

  • Outlook (Prognosis)
    • Your recovery and ability to function after the amputation depend on many things. Some of these are the reason for the amputation, whether you have diabetes or poor blood flow, and your age. Most people can still be active following amputation.

  • References
    • Gittler M. Lower limb amputations. In: Frontera, WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 119.

      Toy PC. General principles of amputations.In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap.14.