How Amputation Works


Recovering from Amputation
Physical therapy is critical for amputees learning to compensate for lost limbs.
Physical therapy is critical for amputees learning to compensate for lost limbs.
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After the amputation surgery, medical caregivers administer antibiotics and carefully control pain levels. Doctors monitor the patient closely. To speed up the healing process, doctors apply compressive bandages, which look like sleeves or sock-like dressings, to the site of the surgery. Compression is important for reducing swelling and increasing blood pressure at the site of amputation. Doctors also encourage circulation by frequent repositioning or stretching of the limb stump, which is more appropriately termed the

residual limb.

An essential part of the recovery process is physical therapy. Not only does therapy improve the healing and function of the residual limb, but it also helps to strengthen bones and muscles elsewhere in the body, which can help compensate for the missing limb. For example, a physical therapist might concentrate on helping the patient use crutches or a walker. A therapy regimen also commonly focuses on patients accomplishing activities of daily living, such as getting out of bed unassisted or dressing without help.

After the wound site is fully healed, the patient might work with a prosthetist to be fit with a prosthetic limb. The prosthetic is individually tailored to the amputee's residual limb with particular care devoted to designing the socket that provides the interface between the patient and the prosthetic. The socket can be continually resized as necessary to accommodate changes in the shape of the residual limb due to reduced swelling or muscle atrophy.

Commonly, amputees must also deal with phantom limb pain, in which patients experience sensory input that feels as if it were coming from the amputated limb. It might seem unusual that this phenomenon would occur, but it actually makes sense. Even though a portion of the body has been amputated, the sensory pathways -- from the nerve stump all the way to the sensory centers of the brain -- are left intact. As the body's nervous system tries to readjust to the missing input, activity along these pathways can be misinterpreted by the brain as coming from the missing limb. Because activity along these sensory pathways often originates from the nerve stump, one treatment for phantom limb pain is to reposition the nerve endings with another surgery.

Despite the challenges faced by amputees, most learn to adapt to their individual situations remarkably well. Many are able to compensate for their lost abilities with the help of prosthetic devices. As the field of prosthetics continues to advance, the types of capabilities that prosthetics are able to restore to amputees will only continue to grow.

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Sources:

  • Bock, Brian. "Civil War Medicine: Amputations." 5/24/2008. http://www.powerweb.net/bbock/war/amputate.html
  • CBS News. "Climber Describes Amputation Ordeal." 5/9/2003. http://www.cbsnews.com/stories/2003/05/02/national/main551979.shtml
  • Chen, Andrew L., MD., M.S., "Amputation - traumatic." Medline Plus. 9/26/2006. http://www.nlm.nih.gov/medlineplus/ency/article/000006.htm
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  • National Limb Loss Information Center. "Amputation Statistics by Cause: Limb Loss in the United States." 2008.
  • http://www.amputee-coalition.org/fact_sheets/amp_stats_cause.pdf
  • Smith, Douglas G., MD. Michael, John W., MEd., CPO. Bowker, John H., MD. Atlas of Amputation and Limb Deficiencies, Surgical, Prosthetic and Rehabilitation Principles. "General Principles of Amputation Surgery." American Academy of Orthopaedic Surgeons, 2004.
  • Stansbury, Lynn G., MD., MPH., FACP. Branstetter, Joanna G., MD. Lalliss, Steven J., MD. "Amputation in Military Trauma Surgery." The Journal of Trauma.Vol. 63, no. 4, pp.940-944. October 2007.
  • Vanderwerker, Earl E., Jr., MD. "A Brief Review of the History of Amputations and Prostheses." The Association of Children's Prosthetic-Orthotic Clinics. Vol. 15, no. 5, pp.15-16. 1976.
  • VascularWeb. "Amputation." 11/7/2007. http://www.vascularweb.org/patients/NorthPoint/Amputation.html

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