Amputation is the removal of a body extremity by trauma or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems. A special case is the congenital amputation, a congenital disorder, where foetal limbs have been cut off by constrictive bands. Unlike many non-mammalian animals (such as lizards that shed their tails), once removed, human extremities do not grow back. A transplant or prosthesis is the only option for recovering the loss.
- Types of lower limb amputation include:
- ankle disarticulation (Syme, Pyrogoff)
- below-knee amputation (transtibial)
- knee-amputation (knee disarticulation)
- above knee amputation (transfemoral)
- rotation/rotationplasty (Foot being turned around and reattached to allow the ankle joint to be used as a knee.)
- hip disarticulation
- hemipelvectomy
The foot will be amputated through the ankle joint leaving the tibia and fibula in tact. This can be limiting to the amputee for the types of prosthetic devices due to the lack of room from the end of the residual limb to floor.
Transtibial Prosthesis
A transtibial amputation (sometimes one sees transtibal amputation) is an amputation above the foot but below the knee. Transtibial amputees have the greatest hope of regaining normal mobility. The knee is the part of the leg involving the most complex biomechanics; as this is intact for all transtibial amputees, the process of mimicking native leg movement becomes much easier for this population.
Transfemoral Prosthesis
A transfemoral prosthesis is an artificial limb that replaces a leg missing above the knee. Transfemoral amputees can have a very difficult time regaining normal movement. In general, a transfemoral amputee must use approximately 80% more energy to walk than a person with two whole legs.This is due to the complexities in movement associated with the knee.
Knee Disarticulation
A knee disarticulation is an amputee that requires a prosthesis that usually weight bears from the remaining condyles of the femur. The knee cap, tibia and fubula have been removed.
Rotationplasty
is an operative procedure where a portion of a limb is removed, while the remaining limb below the involved portion is rotated and reattached. This procedure is used when a portion of an extremity is injured or involved with a disease, such as cancer.
The operation is also called a Van-ness rotation.
Hip Disarticulation
A hip disarticulation in most cases has a complete pelvis and will be missing the femur and below amputated.
Hemipelvectomy
A hemipelvectomy is a high level pelvic amputation. Along with hip-disarticulations, hemipelvectomies are the rarest of lower extremity amputations. In some cases, an internal hemipelvectomy can be performed, which is a limb-sparing procedure. A complete hemipelvectomy, however, is the amputation of half of the pelvis and the leg on that side.
This type of procedure is also called transpelvic amputation.
