Ottobock | Before a leg amputation

Summary

Preparing yourself for a planned amputation

You may have known about your amputation surgery for a while or may have just found out. Either way, we understand that this is difficult to hear. Remember you are not alone, your treatment team, family, and loved ones are there to support you. 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 afterward.

Here are a few of the topics they’ll discuss with you, and that you’ll learn about in this article:

The different kinds of lower limb amputations (“amputation levels”), and what to know about the kind you’ll experience
Important ways to start preparing for your amputation surgery, and how it will impact your everyday life
How and where to find support for your daily life with lower limb difference

Get in touch with experts

Even though it’s so important, many people don’t realise that you can have an influence on who will be treating you. Your care team includes everyone who looks after you during and after the amputation. The team includes your doctor, nurses, prosthetist, physiotherapist, and occupational therapist. It’s important that you are treated by specialists with plenty of experience with leg amputees. Here you will find information 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 amputation

Common reasons for lower limb amputation

An amputation is the surgical removal of part of the body and is required when an injured or diseased body part is not expected to heal and as a result poses a risk the patient’s life. Causes may include circulatory disorders, infections, accidents, cancer or a congenital limb difference (dysmelia). In some 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.

FirstSpiritExport,OBISCM-1557,web_site,prosthetics_2,infos_for_amputees

Amputation due to circulatory disorders

One of the most common causes of amputations in the Western world result from occlusive arterial diseases (inadequate blood flow due to narrowing of the arteries). With a circulatory disorder, the supply of oxygen to the leg is no longer sufficient, and those affected often experience pain and find walking uncomfortable. Their leg or foot may feel colder than the rest of the body and sometimes appear 'bluish' in colour. A lower limb amputation is only performed if blood circulation cannot be restored by other vascular surgery procedures.

Amputation due to diabetic foot syndrome

Diabetic foot syndrome (DFS) is one of the most common causes for leg or foot amputations. Though the number of people with diabetes is rising, the number of amputations is changing very little, as a result of better ways of controlling the disease, treatment methods and knowledge.

High blood sugar levels can damage the nerves and blood vessels in your body. If the nerves in your legs or feet become damaged (neuropathy) you may no longer be able to feel pain, this can then lead to cuts or ulcers going un-noticed resulting in infections.
Diabetes can sometimes result in less perspiration, this can sometimes cause your feet and legs to dry out and crack.
Uncontrolled diabetes may also affect circulation, causing blood to move more slowly, which makes it more difficult for the body to deliver nutrients to wounds, affecting wound healing.

Amputation after an accident

The frequency of amputations after accidents – including work and traffic accidents, for example – has decreased considerably in the Western world. There are many reasons for this, including higher occupational health and safety standards as well as advances in medical treatment. Progress in the fields of intensive care and surgery means that the nerves, vessels, bones and soft tissue of injured limbs can be restored in many cases, so now an amputation is not always required as the last resort.

Amputation after an infection

Any would is open to infection, however, amputations resulting from infections have become extremely rare since Louis Pasteur discovered antibiotics in 1877. High sterile standards in medical treatment and tetanus shots are another reason for the decrease. Nevertheless, remaining vigilant even with the tiniest injury and looking out for signs of inflammation, reddening of the skin, swelling, fever and pain in a wound can help.

Amputation levels

Determining the appropriate amputation level

The term amputation level describes the location at which a body part is amputated. It is determined by your surgeon before the operation and is based on the reason for amputating.

If the surgery is planned, your prosthetist may be included in the consultations beforehand, as they can help find the right device for you based on your amputation, lifestyle, and favourite activities.

FirstSpiritExport,OBISCM-1557,web_site,prosthetics_2,mobility_after_amputation

Transtibial amputation (lower leg amputation)

For a transtibial amputations (also known as 'below knee' or 'BK') the amputation occurs through the tibia and fibula bones of the lower leg.

Prostheses to plan for:

A prosthetic foot such as the Taleo or Empower
A custom socket, which contains the residual limb (commonly referred to as the 'stump') and connects it to the prosthesis
Connectors and adaptors for different components of your prosthesis

Knee disarticulation

In knee disarticulation surgery the knee is separated and lower leg is removed. The entire thigh is retained.

Prostheses to plan for:

A prosthetic foot such as the Taleo or Empower
A prosthetic knee joint such as the C-Leg 4
A custom socket, which contains the residual limb (commonly referred to as the 'stump') and connects it to the prosthesis
Connectors and adaptors for different components of your prosthesis

Transfemoral amputation (above-knee amputation)

With a transfemoral amputation (also known as 'above knee' or 'AK')
, the amputation occurs through the femur bone.

Prostheses to plan for:

A prosthetic foot such as the Taleo or Empower
A prosthetic knee joint such as the C-Leg 4
A custom socket, which contains the residual limb (commonly referred to as the 'stump') and connects it to the prosthesis
Connectors and adaptors for different components of your prosthesis

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.

Prostheses to plan for:

A prosthetic foot such as the Taleo or Empower
A prosthetic knee joint such as the C-Leg 4
A prosthetic hip joint such as the Helix3D
A custom socket, which contains the pelvic area and connects it to the prosthesis
Connectors and adaptors for different components of your prosthesis

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.

Prostheses to plan for:

A prosthetic foot such as the Taleo or Empower
A prosthetic knee joint such as the C-Leg 4
A prosthetic hip joint such as the Helix3D
A custom socket, which contains the remaining pelvic area and connects it to the prosthesis
Connectors and adaptors for different components of your prosthesis

Treatment team

Experts that are there for you

Loosing your leg is a major medical procedure, a team of experts from various disciplines will handle your treatment before and after your amputation. We have listed the members of this team here and described the role each of them plays in your treatment. Your prosthetist will play a pivotal role within this team. If you can, it may be beneficial to speak with them before your amputation.

Prosthetist

Your prosthetist will play central role after your amputation surgery. They will fit you with a suitable prosthesis and can offer advice if you have questions. Leading up to an amputation, your prosthetist may discuss with your surgeon what your residual limb should look like if possible. They can recommend experienced physiotherapists 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, your prosthetist will clarify your needs and preferences and discuss the various treatment options with you. Based on this, they select the appropriate prosthetic components and fabricate your prosthesis with a customised prosthetic socket.

Your prosthetist is available to you for all questions related to your prosthesis.

Relatives and social environment

Your family and friends will also contribute to your rehabilitation, by supporting you to the best of their ability in daily life. What role the play exactly will depend on you needs and requirements but they can help with everyday tasks as well as with the daily use of your prosthesis.

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

Further Information

Man after amputation looks out of window

Living with a leg amputation

After leg amputation

Read about what to expect after a leg amputation, how to heal your residual limb, and finding the right rehabilitation facilities.

After leg amputation

First steps with a prosthesis

Rehabilitation and leg prosthesis

Discover detailed information on caring for the residual limb, handling prostheses and gait training for a life with a leg prosthesis.

Rehabilitation and leg prosthesis

Man walking with a C-Leg 4 from Ottobock.

Discover prosthetic legs

Prosthetic legs

Learn how prosthetic legs help people regain their mobility, rebuild their confidence, and explore their world again.

Prosthetic legs

3 results out of 3

Preparing for your amputation surgery

Preparing yourself for a planned amputation

Get in touch with experts

Common reasons for lower limb amputation

Amputation due to circulatory disorders

Amputation due to diabetic foot syndrome

Amputation after an accident

Amputation due to cancer tumours

Amputation after an infection

Determining the appropriate amputation level

Foot amputation

Transtibial amputation (lower leg amputation)

Knee disarticulation

Transfemoral amputation (above-knee amputation)

Hip disarticulation

Hemipelvectomy

Experts that are there for you

Surgeon

Nursing staff

Physiotherapists and occupational therapists

Prosthetist

Relatives and social environment

Further Information