Lower Extremity Amputation

Excerpt

Over 150,000 people undergo amputations of the lower extremity in the United States each year. This incidence is directly proportional to rates of peripheral arterial occlusive disease, neuropathy, and soft tissue sepsis. This correlation is due to the increased incidence of diabetes mellitus, which is present in 82% of all vascular-related lower extremity amputations in the United States. Patients with diabetes mellitus have an astounding 30 times greater lifetime risk of undergoing an amputation when compared to patients without diabetes mellitus, which translates to an economic strain in healthcare systems of over $4.3 billion in annual costs in the USA alone. Trauma to the lower extremity can lead to amputation in over 20% of patients when associated with severe wound contamination and significant soft tissue loss. Battle-related explosive events can lead to amputation in 93% of cases and approximately 2% of combat casualties least to limb amputation.

This activity focuses on amputations at the level of the femur and distally. It covers above-knee, through-knee, and below-knee amputations (see Image. Digital Amputation). In addition, it describes the technique for certain foot amputations (Syme, Chopart, Boyd), but the reader is encouraged to seek further in-depth text to review these techniques. Amputations are procedures performed surgically, although on rare occasions and in limited settings, they can be performed employing cryoamputation.