Effects of Amputation

The effects of an amputation will be very much dependant upon which limb has been amputated, the size of the remaining stump and any pre-existing medical conditions.

Effects can be physical, psychological or both.

Some amputees may also experience Phantom Limb Pain.

The risks of complications from amputation are influenced by a number of factors such as age, type of amputation and general state of health.

Complications that may arise from amputation include;

  • Heart complications, such as heart attack or heart failure
  • Blood clots (venous thrombosis)
  • Infection at the site of surgery
  • Pneumonia
  • Further surgery being required

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  • Phantom Limb Pain
  • Physical
  • Psychological
  • Phantom Limb Pain

    Phantom limb pain is the pain that appears to come from the limb that has been amputated.

    Using the term ‘phantom’ does not mean that the pain being experienced is not real, phantom limb pain has been confirmed using scans of the brain.

    The symptoms can range from mild to severe and can, in some cases, be quite debilitating.

    Whilst the causes of phantom limb pain remain unclear there are three theories which try to explain it;

    • The peripheral theory argues that phantom limb pain may be the result of nerve endings around the stump forming clusters, known as neuromas. It is thought these may generate abnormal electrical impulses that the brain interprets as pain
    • The spinal theory suggests that the lack of sensory input from the amputated limb causes chemical changes in the central nervous system. This leads to confusion in certain areas of the brain, triggering symptoms of pain
    • The central theory suggests that the brain has a memory of the amputated limb and its associated nerve signals. The symptoms of pain are due to the brain trying to recreate the memory but failing as it is not receiving the feedback it expected
  • Physical

    There are two types of amputation, lower limb and upper limb.

    Lower limb amputations

    The most common type of major amputation is that of a lower limb, known as transtibial amputation. This is where the bottom section of the leg is amputated below the knee.

    Other types of lower limb amputation include;

    • Lower digit amputation – one or more of the toes are amputated
    • Transfemoral – where both the bottom half of the leg and part of the thigh above the knee are amputated
    • Double lower amputation – both legs are amputated
    • Knee disarticulation – the amputation is performed through the middle of the knee joint
    • Partial foot amputation – where the toes and lower half of the foot are amputated
    • Hip disarticulation – amputation takes place through the hip joint removing the entire leg
    • Hemipelvectomy – an entire leg and a section of the pelvis are amputated
    • Upper limb amputations

    The majority of upper limb amputations are needed because the hand and arm have been damaged by a traumatic injury.

    The main types of upper limb amputation are;

    • Upper digit amputation – where the thumb or one or more of the fingers are amputated
    • Transhumeral – the hand and a section of the arm are amputated above the elbow
    • Transradial – the hand and a section of the arm are amputated below the elbow
    • Partial hand amputation – section of the hand is amputated
    • Shoulder disarcticulation – amputation occurs through the shoulder joint removing the entire arm
    • Double upper amputations – both hands and some of the arms are amputated
    • Forequater amputation – the entire arm is amputated along with a section of the shoulder blade and collar bone
    • Wrist disarticulation – the amputation occurs through the wrist joint removing the hand
    • Elbow disarticulation – the amputation occurs through the elbow joint removing the hand, wrist and forearm
  • Psychological

    Losing a limb can bring on many different emotions, such as grief and bereavement.

    The psychological impact of having a limb amputated is just as important to deal with as coping with the physical aspect.

    An amputation can have a psychological impact for three main reasons;

    • The patient has to cope with the loss of sensation from the amputated limb
    • The patient has to cope with the loss of function from the amputated limb
    • The patient’s sense of body image and other people’s perception of body image will change
    • Following amputation is it common for a patient to feel negative emotions and have negative thoughts. For those who suffer emergency amputation this particularly the case.

    Negative thoughts and emotions experienced following an amputation can include;

    • Depression
    • Anxiety
    • Denial
    • Grief
    • Feeling suicidal