When you undergo amputation surgery, you are profoundly challenged at every level of your being – physically, emotionally, mentally and spiritually. The indisputable fact is that your limb is permanently gone. How you respond to this reality depends on whether or not you give in to despair, and will determine whether you grow as a human being and heighten your appreciation of living.
The challenges you face are obvious, but the opportunities to grow in the face of adversity are just as dramatic. We hope that the information in this guide will answer some factual and practical questions about limb loss, but also inspire you to find positive meaning in your experience.
The real challenges that accompany the loss of your limb cannot be made to disappear, but through rehabilitation, their negative effects can be minimised.
The word ‘rehabilitate’ means ‘restore’. After surgery, your rehabilitation goal should be to restore your body, mind and spirit.
Historically, there has never been a better time to be living with limb loss. Modern technology is helping amputees live their best lives every day. Combining innovative prosthetic solutions with the experience of inspiring influencers, can help you adapt and resume doing the things you love, although sometimes it may be in new ways.
“Regardless of the causes, it is a traumatic and life-changing experience to lose a limb. Your body is permanently altered, almost all aspects of your life are affected, and you may feel that no one could possibly understand what you are experiencing.”
Ernst van Dyk
Reasons for amputation
Amputations are done to remove a part of the body, a limb, or part of a limb to treat recurrent infection or gangrene in peripheral vascular disease, to remove cancerous tumours, and to treat severe trauma. The remaining portion of the limb (if applicable) is called the stump, or residual limb.
Amputations are performed to:
- Save a life
- Relieve symptoms of a disease
- Improve function
- Improve quality of life
Every year, the majority of new amputations occur due to complications of the vascular system (pertaining to the blood vessels). The single largest cause is, therefore, vascular disease, including diabetes and peripheral arterial disease (PAD), followed by victims of trauma and accidents and cancer.
Below-the-knee (BK or transtibial) amputations are the most common, representing 71% of dysvascular amputations. Among those living with limb loss in the USA, the main causes of amputations are:
- Vascular Disease: 54%
- Trauma: 45%
- Cancer: Less than 2%
Diabetes is a major risk factor
Diabetes affects 8,3% of the US population, and the number of amputations caused by diabetes increased by 24% from 1988 to 2009. The International Diabetes Federation predicts that the current global prevalence of diabetes will burgeon from 285 million people to reach 435 million people by the year 2030. It is also projected that the amputee population will more than double by the year 2050. Amputation is four times more likely in diabetics than in non-diabetics.
Other risk factors of peripheral arterial disease include:
- An unhealthy diet
- Being overweight
- Lack of exercise
- High cholesterol levels
- High blood pressure
- Genetic factors
Levels of amputation
Depending on the cause, amputations are carried out at different levels on the limb. The ‘level’ or ‘site’ of amputation refers to the location of the amputation of the affected limb. The amputation level is important, as it partly determines the residual limb’s functional ability, strength and mobility – requirements to use a prosthesis.
Your doctor will consider every aspect of your unique case and select the best level based on what is best for your health.
Glossary of terms
These common terms describe different types of amputation:
A. Residual limb: the portion of a limb remaining after an amputation.
B. Transfemoral amputation: amputation through the thigh bone, between the hip and the knee, also called “above knee” or “AK.“
C. Knee disarticulation: amputation through the knee joint, also called a “KD.“
D. Transtibial amputation: amputation through the calf and shin bones, between the knee and the ankle, also called “below knee” or “BK.“
E. Ankle disarticulation: amputation through the ankle.
F. Transmetatarsal amputation: amputation through the forefoot. This may also be referred to as a Symes Amputation.
G. Bilateral amputation: amputation of both legs.