Amputation

Definition: It may be define as surgical removal of a limb or part of a

limb through the bone
Disarticulation – through the joint

Criteria of an ideal stump

1. The stump should be of optimum length
2. Smooth and rounded
3. It should be firm
4. Scar should be freely mobile
5. vascularity of flap should be normal
6. Opposing group of muscles should be sutured over the end of the
stump
7. Scar should neither be adherent nor be infolded
8. There should not be any complication like painful neuroma
9.

Complication
Early Late
Primary haemorrhage Pain (
Reactionary haemorrhage Bone spur
Skin necrosis Adharent painful scar
Haematoma Stump neuroma ( due to
Infection outgrowth of nerve fibrils that
Wound dehiscence attach to scar, muscle, or fibrous
DVT tissue)
Pulmonary embolism Phantom limb
Causalgia – sympathetic
overactivity
Jactitation – intermittent spasm of
stump
Flexion contracture of proximal
joint

Skin Muscle Artery Nerve Joint

 ecze If poor   the joint above

ma excessi vascularit Painful the site of
 purul ve y gives neuro amputation may
ent lumps muscle  c mas become stiff or
 fissur left it old attach deformed
ing & will  b ed to  Deformities are
ulceration produce lue the fixed flexion & fixed
 infect unstabl color scar abduction in above
ed
 epidermoid e, stump knee ….. Fixed
cyst loose  li flexion in bellow
 Squa cushion able knee amputations .
mouse cell to
carcinoma ulcera
 Verru te
cous
hyperplasia

Dead - when arterial occlusive disease is

severe enough to cause infarction of
macroscopic portions of tissue,

Deadly - when the putrefaction and

infection of moist gangrene spreads to
surrounding viable tissues.

Deadloss – 1. Unrecoverable traumatic

damage
2. Contracture or paralysis makes the limb
impossible to use
 Table-40.2: Nomenclature of
amputations by levels

Name Part of the limb removed

Upper limb
1. Forequarter Scapula + lateral 2/3 of clavicle + whole
amputation of the upper limb
2. Shoulder Removal through the gleno-humeral joint
disarticulation
3. Above elbow Through the arm
amputation
4. Elbow Through the elbow
disarticulation
5. Below elbow Through the forearm bones
amputation
6. Wrist Through the radio-carpal joint
disarticulation
7. Ray amputation Removal of a finger with respective
metacarpal from carpo-metacarpal joint
8. Krukenburg's Making 'forceps' with two forearm bones
amputation
Lower limb
9. Hindquarter Whole of the lower limb with one side of
amputation the ilium removed
10. Hip Through the hip
disarticulation
11. Above-knee Through the femur
amputation
12. Knee Through the knee
disarticulation
13. Below-knee Through the tibia-fibula