Limb amputation

Amputation
J. McKnight, who lost his limbs in a railway accident in 1865, was the second recorded survivor of a simultaneous triple amputation.
Classification and external resources
Specialty	emergency medicine
ICD-10	T14.7
MeSH	D000673
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Amputation is the removal of a limb by trauma, medical illness, 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 that of congenital amputation, a congenital disorder, where fetal limbs have been cut off by constrictive bands. In some countries, amputation of the hands, feet or other body parts is or was used as a form of punishment for people who committed crimes. Amputation has also been used as a tactic in war and acts of terrorism; it may also occur as a war injury. In some cultures and religions, minor amputations or mutilations are considered a ritual accomplishment.

In the US, the majority of new amputations occur due to complications of the vascular system (the blood vessels), especially from diabetes. Between 1988 and 1996, there were an average of 133,735 hospital discharges for amputation per year in the US.

Lower limb, or leg, amputations can be divided into two broad categories - minor amputations and major amputations, Minor amputations generally refers to the amputation of digits. Major amputations are commonly referred to as below-knee amputation, above-knee amputation and so forth. To avoid ambiguity the correct terminology for major amputations is described in ISO 8549-2:1989, these being:

Common partial foot amputations include Chopart, Lisfranc and ray amputations, Common forms of ankle disarticulations include Syme, Pyrogoff and Boyd. A less commonly occurring major amputation is the Van Ness rotation/rotationplasty (foot being turned around and reattached to allow the ankle joint to be used as a knee).

The correct terminology for arm, or upper-limb amputations is also described in ISO 8549-2:1989, these being:

A variant of the trans-radial amputation is the Krukenberg procedure in which the radius and ulna are used to create a stump capable of a pincer action.

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