separation; limb removal; separation; disarticulation; limb removal Latin: amputare = to cut off, to remove
The term amputation describes the surgical or, in rare cases, traumatic separation of a body part, limb or other appendage of the body. Such operations only become necessary when the preservation of the corresponding body part is no longer possible or the life and health of the patient is irrevocably endangered. If a limb that is not supplied with blood has to be removed after a failed replantation attempt, one speaks of a reamputation.
How can it be ensured that the amputation will really be necessary?
Due to the many different causes of amputation, diagnostics must also resort to different means. At the beginning, of course, there is a catchy questioning of the patient (anamnesis), the collection of typical risk factors such as smoking or diabetes mellitus and a physical examination. If there is a circulatory disorder, the extent to which the blood flow in the affected vessels is restricted must be investigated.
First of all, it must be determined whether pulses can still be felt in the affected extremity and whether adequate blood pressure can be measured. If, as is usually the case, the legs are affected, functional tests can be carried out. For example, a treadmill is used to test how far the patient can walk.
Reduced blood flow is made visible by means of a vascular imaging in an X-ray with contrast medium (angiography) or also in ultrasound (duplex sonography). These examinations taken together determine whether the limb can be preserved. Imaging techniques are also used in the case of tumours or accident-related (traumatic) injuries.
- Computed tomography (CT) or
- A radioactive imaging process (scintigraphy).
These symptoms may indicate a necessary amputation
Signs of a severe circulatory disorder in peripheral arterial occlusive disease (PAVK) are pain, which occurs mainly during exercise, but is also present at rest later. The affected limb is cold and pale due to reduced blood circulation. Eventually the tissues die (necrosis), in severe cases an infection develops on them, which can spread to the body (sepsis) and must be treated.
If malignant tumours develop in: they must always be treated. Through their malignant infiltrating growth, the tumours destroy surrounding tissue, which in advanced stages manifests itself in pain, palpable and visible thickening and functional limitations. To prevent the tumour from spreading to other tissues (metastasis), the tumour must be removed quickly, but sometimes this is only possible by amputation.
- The connective tissues of the extremities (sarcomas)
- The bone (osteosarcomas)
- The muscles (rhabdomyosarcoma)
- The vessels (angiosarcoma) or
- The cartilage (chondrosarcomas)
In the case of serious injuries caused by any trauma, such as large cuts, the symptoms are due to circulatory problems, nerve damage that can lead to loss of sensation (loss of sensitivity) or even paralysis, and direct painful tissue damage. Likewise, severe bone fractures or joint damage, where normal function cannot be restored, are the result of trauma. If there is an infection, the affected part of the body will be reddened and swollen, sometimes even overheated. If the inflammation spreads via the bloodstream over the body (sepsis = blood poisoning), fever and chills develop. If this is not treated, shock symptoms with a drop in blood pressure and increased heart rate can endanger the patient’s life through circulatory failure.