Amputation

Amputation
J. McKnight.jpg
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
Specialtyemergency medicine
ICD-10T14.7
D000673

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.[1][2][3] 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.[4][5][6]

When done by a person, the person executing the amputation is an amputator[7]. The amputated person is called an amputee[8].

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.[9] In 2005, just in the US, there were 1.6 million amputees.[10] In 2013, the US has 2.1 million amputees. Approximately 185,000 amputations occur in the United States each year. In 2009, hospital costs associated with amputation totaled more than $8.3 billion.[11]. There will be an estimated 3.6 million people in the US living with limb loss by 2050.[12] African‐Americans are up to four times more likely to have an amputation than white Americans.[13]

Types

Leg

A diagram showing an above the knee amputation

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,[14] these being:

  • partial foot amputation - amputation of the lower limb distal to the ankle joint.
  • ankle disarticulation - amputation of the lower limb at the ankle joint.
  • trans-tibial amputation - amputation of the lower limb between the knee joint and the ankle joint, commonly referred to as a below-knee amputation.
  • knee disarticulation - amputation of the lower limb at the knee joint.
  • trans-femoral amputation - amputation of the lower limb between the hip joint and the knee joint, commonly referred to an above-knee amputation.
  • hip disarticulation - amputation of the lower limb at the hip joint.
  • trans-pelvic disarticulation- amputation of the whole lower limb together with all or part of the pelvis.This is also known as a hemipelvectomy or hindquarter amputation.

Common partial foot amputations include Chopart, Lisfranc and ray amputations, Common forms of ankle disarticulations include Syme,[15] 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).

Arm

The 18th century guide to amputations

The correct terminology for arm, or upper-limb amputations is also described in ISO 8549-2:1989,[14] these being:

  • partial hand amputation
  • wrist disarticulation
  • trans-radial amputation, commonly referred to as below-elbow or forearm amputation
  • elbow disarticulation
  • trans-humeral amputation, commonly referred to as above-elbow amputation
  • shoulder disarticulation
  • forequarter amputation

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.

Other

  • Face:

Many of these facial disfigurings were and still are done in some parts of the world as punishment for some crimes, and as individual shame and population terror practices.

Hemicorporectomy, or amputation at the waist, and decapitation, or amputation at the neck, are the most radical amputations.

Genital modification and mutilation may involve amputating tissue, although not necessarily as a result of injury or disease.

Self-amputation

In some rare cases when a person has become trapped in a deserted place, with no means of communication or hope of rescue, the victim has amputated his or her own limb. The most notable case of this is Aron Ralston, a hiker who amputated his own right forearm after it was pinned by a boulder in a hiking accident and he was unable to free himself for over five days.[citation needed]

Body integrity identity disorder is a psychological condition in which an individual feels compelled to remove one or more of their body parts, usually a limb. In some cases, that individual may take drastic measures to remove the offending appendages, either by causing irreparable damage to the limb so that medical intervention cannot save the limb, or by causing the limb to be severed.

Other Languages
العربية: بتر
asturianu: Amputación
azərbaycanca: Amputasiya
беларуская: Ампутацыя
български: Ампутация
català: Amputació
čeština: Amputace
dansk: Amputation
Deutsch: Amputation
Ελληνικά: Ακρωτηριασμός
español: Amputación
Esperanto: Amputo
euskara: Anputazio
فارسی: قطع عضو
français: Amputation
Gaeilge: Teascadh
galego: Amputación
한국어: 절단 (의학)
հայերեն: Ծայրատում
hrvatski: Amputacija
Bahasa Indonesia: Amputasi
interlingua: Amputation
italiano: Amputazione
עברית: קטיעה
қазақша: Ампутация
Kreyòl ayisyen: Anpite
Кыргызча: Ампутация
Latina: Amputatio
magyar: Amputáció
македонски: Ампутација
Nederlands: Amputatie
日本語: 切断 (医学)
norsk: Amputasjon
oʻzbekcha/ўзбекча: Amputatsiya
polski: Amputacja
português: Amputação
română: Amputare
русский: Ампутация
Simple English: Amputation
slovenčina: Amputácia
slovenščina: Amputacija
српски / srpski: Ампутација
srpskohrvatski / српскохрватски: Amputacija
suomi: Amputaatio
svenska: Amputation
Tagalog: Gapong
тоҷикӣ: Ампутатсия
Türkçe: Ampütasyon
українська: Ампутація
中文: 截肢