What is the role of prosthetics in lower-extremity amputations?

Updated: Apr 29, 2021
  • Author: Janos P Ertl, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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Answer

Great advances have been made in the treatment of severe lower-extremity trauma and PVD. Revascularization, internal fixation of fractures, microvascular techniques, and free tissue transfer procedures have improved and favorably enhanced the patient's outcome. Failure of these techniques when extensive efforts have been pursued may result in a negative patient outlook. Amputation may be viewed as a failure by both the surgeon and the patient. The patient may picture himself or herself as incomplete by societal standards. The current view is that amputation surgery is a reconstructive procedure intended to return a patient to an active life.

Compared with the changes that have taken place in the field of prosthetics, amputation techniques have changed little over the years. Even with a well-performed amputation and a well-fitted prosthesis, some patients have persistent symptoms of residual extremity pain, swelling, and a sense of instability, as well as have a decreased length of prosthetic wear. These patients pose a challenge for the reconstructive surgeon. The effects of previous surgery, altered anatomy, muscle and bone atrophy, and aerobic deconditioning are important variables in predicting the success of amputation surgery.


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