Abstract
Advanced surgical techniques, rehabilitation protocols, and prosthetic technologies offer a high degree of function for people with a limb amputation as a result of a mangled or diseased extremity. A "reconstructive" amputation surgery creates a limb well suited for prosthetic use. Vigilant postoperative care and carefully designed and monitored care plans are essential for successful rehabilitation. Prosthetic devices, individually designed around the needs of each patient, restore gait and grasp for activities of daily living and beyond. Frequent communication and coordination between rehab team members are critical to successful outcomes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Doukas WC, et al. The Military Extremity Trauma Amputation/Limb Salvage (METALS) Study: Outcomes of Amputation Versus Limb Salvage Following Major Lower-Extremity Trauma. J Bone Joint Surg. 2013;95(2):138–45.
Staruch RMT, et al. Comparing the surgical timelines of military and civilians traumatic lower limb amputations. Ann Med Surg. 2016;6:81–6.
Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil. 2008;89:422–9.
Esquenazi A, Yoo SK. Lower limb amputations – epidemiology and assessment. PM&R Now website. https://now.aapmr.org/lower-limb-amputations-epidemiology-and-assessment/#references. Updated 5/03/2016.
Stansbury LG, et al. Amputations in U.S. Military personnel in the current conflicts in Afghanistan and Iraq. J Orthop Trauma. 2008;22:1.
Clasper J, Ramasamy A. Traumatic amputations. Br J Pain. 2013;7(2):67–73.
Wallace D. Trends in traumatic limb amputation in Allied Forces in Iraq and Afghanistan. J Mil Vet Health. 2012;20(2):31–5.
Honkamp N, Amendola A, Hurwitz S, Saltzman CL. Retrospective review of eighteen patients who underwent transtibial amputation for intractable pain. J Bone Joint Surg Am. 2001;83(10):1479–83.
Smith DG, McFarland LV, Sangeorzan BJ, Reiber GE, Czerniecki JM. Postoperative dressing and management strategies for transtibial amputations: a critical review. J Rehabil Res Dev. 2003;40(3):213–24.
Nawijn SE, van der Linde H, Emmelot CH, Hofstad CJ. Prosthetics Orthot Int. 2005;29(1):13–26.
Smith D. General principles of amputation surgery. In: Smith D, Michael J, Bowker J, editors. Atlas of amputations and limb deficiencies: Surgical, prosthetic, and rehabilitation principles. 3rd ed. Rosemont: American Academy of Orthopaedic Surgeons; 2004. p. 27–8.
Stevens P, Rheinstein J, Campbell J. Acute postoperative care of the residual limb following transtibial amputation: a clinical practice guideline. Arch Phys Med Rehabil. 2016;97(10):21.
Reichmann JP, Stevens PM, Rheinstein J, Kreulen CD. Removable rigid dressings for postoperative management of transtibial amputations: a review of published evidence. PM&R. 2018;10:516–23. https://doi.org/10.1016/j.pmrj.2017.10.002.
Churilov I, Churilov L, Murphy D. Do rigid dressings reduce the time from amputation to prosthetic fitting? A systematic review and meta-analysis. Ann Vasc Surg. 2014;28(7):1801–8.
Pinzur MS. The dark side of amputation rehabilitation: commentary on an article by COL (Ret) William C. Doukas, MD, et al.: “The Military Extremity Trauma Amputation/Limb Salvage (METALS) study outcomes of amputation versus limb salvage following major lower-extremity trauma”. J Bone Joint Surg. 2013;95(2):e12.
Wurdeman SR, Stevens PM, Campbell JH. Mobility Analysis of AmpuTees (MAAT I): quality of life and satisfaction are strongly related to mobility for patients with a lower limb prosthesis. Prosthetics Orthot Int. 2018;42(5):498–503.
Desmond DM, MacLachlan M. Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation. J Rehabil Res. 2010;33:279–82.
Davidson JH, Khor KE, Jones LE. A cross-sectional study of post-amputation pain in upper and lower limb amputees, experience of a tertiary referral amputee clinic. Disabil Rehabil. 2010;32(22):1855–62.
Ostlie K, Franklin RJ, Skjeldal OH, Skrondal A, Magnus P. Musculoskeletal pain and overuse syndromes in adult acquired major upper-limb amputees. Arch Phys Med Rehabil. 2011;92:1967–73.
Hanley ME, Ehde DM, Jensen M, Czerniecki J, Smith DG, Robinson LR. Chronic pain associated with upper-limb loss. Am J Phys Med Rehabil. 2009;9(88):742–54.
Postema SG, BOngers RM, Brouwers MA, Burger H, Norling-Hermansson LM, REneman MF, Dijkstra PU, and van der Sluis CK. Musculoskeletal complaints in transverse upper limb reduction deficiency and amputation in the Netherlands: prevalence, predictors, and impact on health. Arch Phys Med Rehabil. 2016.
Jones LE, Davidson JH. Save that arm: a study of problems in the remaining arm of unilateral upper limb amputees. Prosthetics Orthot Int. 1999;23:55–8.
Datta D, Selvarajah K, Davey N. Functional outcome of patients with proximal upper limb deficiency--acquired and congenital. Clin Rehabil. 2004 Mar;18(2):172–7.
Nimhurchadha S, Gallagher P, MacLachlan M, Wegener ST. Identifying successful outcomes and important factors to consider in upper limb amputation rehabilitation: an international web-based Delphi survey. Disabil Rehabil. 2013;35(20):1726–33.
Biddiss EA, Chau TT. Upper limb prosthesis use and abandonment: a survey of the last 25 years. Prosthetics Orthot Int. 2007 Sep;31(3):236–57.
Gaston RG, Bracey JW, Tait MA, Loeffler BJ. A novel muscle transfer for independent digital control of a myoelectric prosthesis: the starfish procedure. J Hand Surg Am. 2019;44(2):163.
Stevens PM, Europe’s pursuit of a better transhumeral residual limb, O&P edge, May 2017. https://opedge.com/Articles/ViewArticle/2017-04-21/2017-05_02
Lipshutz RD. Targeted muscle Reinnervation: prosthetic management. In: Krabich JI, Pinzur MS, Potter BK, Stevens PM, editors. Atlas of amputations and limb deficiencies: surgical, prosthetic, and rehabilitation principles. 4th ed. IL, American Academy of Orthopedic Surgeons: Rosemont; 2016. p. 339–50.
Dumanian GA, et al. Ongers RM, Broneuroma and phantom pain in major limb. Amputees Random ClinTrial Ann Surg. 2019;270(2):238–46.
Woo SL, Kung TA, Brown DL, Leonard JA, Kelly BM, Cederna PSI. Regenerative peripheral nerve interfaces for the treatment of post amputation neuroma pain: A Pilot Study. Plast Reconstr Surg Glob Open. 2016;4(12):e1038.
Cheesborough JE, Smith LH, Kuiken TA, Dumanian GA. Targeted muscle reinnervation and advanced prosthetic arms. Semin Plast Surg. 2015;29(1):62–72.
Schiefer M, Tan D, Sidek SM, Tyler JD. Sensory feedback by peripheral nerve stimulation improves task performance in individuals with upper limb loss using a myoelectric prosthesis. J Neural Eng. 2016;13(1):016001.
Ortiz-Catalan M, Hakansson B, Branemark R. An osseointegrated human-machine gateway for long-term sensory feedback and motor control of artificial limbs. Sci Trans Med. 2014;6(257):257re6.
Doukas WC, et al. The Military Extremity Trauma Amputation/Limb Salvage (METALS) Study: outcomes of amputation versus limb salvage following major lower-extremity trauma. J Bone Joint Surg. 2013;95(2):138–45.
Berke G, Rheinstein J, Michael J, Stark G. Biomechanics of ambulation following partial foot amputation: a prosthetic perspective. J Prosthet Ortho. 2007;19(8):85–8.
Irolla C, Rheinstein J, Richardson R, Simpson C, Carroll K. Evaluation of a graduated length prosthetic protocol for bilateral Transfemoral amputee prosthetic rehabilitation. J Prosthet Ortho. April 2013;25(2):84–8.
Tyler R. The ewing amputation: the first human implementation of the agonist-antagonist myoneural interface. Plast Reconstr Surg. 2018;6(11):e1997.
Hunter CW, Yang A, Davis T. Selective radiofrequency stimulation of the dorsal root ganglion (DRG) as a method for predicting targets for neuromodulation in patients with post amputation pain: a case series. Neuromodulation. 2017;20(7):708–18.
Soin A, Shah NS, Fang ZP. High-frequency electrical nerve block for post amputation pain: a pilot study. Neuromodulation. 2015 Apr;18(3):197–205.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Rheinstein, J., Carroll, K., Stevens, P. (2021). Prosthetic Care for the Mangled Extremity. In: Pensy, R.A., Ingari, J.V. (eds) The Mangled Extremity. Springer, Cham. https://doi.org/10.1007/978-3-319-56648-1_17
Download citation
DOI: https://doi.org/10.1007/978-3-319-56648-1_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-56647-4
Online ISBN: 978-3-319-56648-1
eBook Packages: MedicineMedicine (R0)