Skip to main content

Abstract

In austere environments, complex, protracted, and costly limb-salvage procedures are rarely available, and amputation is a common outcome of severe limb injuries. Most often, only basic prosthetic and rehabilitation capacities are present, and this limits the scope of procedures and the rehabilitative potential. Psychological, sociocultural and economic considerations are also important determinants. This chapter addresses the general principles of amputation surgery and discusses indications, techniques, limitations, and complications for the most common surgical procedures for upper and lower extremity amputations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Renzi R, Unwin N, Jubelirer R, Haag L. An international comparison of lower extremity amputation rates. Ann Vasc Surg. 2006;20(3):346–50.

    Article  PubMed  Google Scholar 

  2. Aleccia J. Lomb loss, a grim, growing lobal crisis. 2010. Available at http://haitiamputees.msnbc.msn.com/news/2010/03/19/4040341-limb-loss-a-grim-growing-global-crisis. Accessed 19 Oct 2013.

  3. Chalya P, Mabula JB, Dass RM, et al. Major limb amputations: a tertiary hospital experience in northwestern Tanzania. J Orthop Surg Res. 2012. Available at http://www.josr-online.com/content/7/1/18. Accessed 19 Oct 2013.

  4. Akiode O, Shonubi AM, Musa A, Sule G. Major limb amputations: an audit of indications in a suburban surgical practice. J Natl Med Assoc. 2005;97(1):74–8.

    PubMed  PubMed Central  Google Scholar 

  5. Swann M, Walker GF. Amputations in developing countries. Br Med J. 1966;1(5494):1041–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Smith DG, Michael JW, Bowker JH, editors. Atlas of amputations and limb deficiencies. 3rd ed. Chicago: AAOS Publication; 2004.

    Google Scholar 

  7. Abbas ZG, Archibald LK. Challenges for management of the diabetic foot in Africa: doing more with less. Int Wound J. 2007;4:305–13.

    PubMed  Google Scholar 

  8. Giannou C, Baldan M. War surgery, vol. 1. Geneva: ICRC; 2009.

    Google Scholar 

  9. Wolfson N. Amputations in natural disasters and mass casualties: staged approach. Int Orthop. 2012;36(10):1983–8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rigal S. Extremity amputation: how to face challenging problems in a precarious environment. Int Orthop. 2012;36(10):1989–93.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ge L, et al. Skin grafts – indications, applications and current research. Available at http://www.intechopen.com/books/skin-grafts-indications-applications-and-current-research/skin-graft-preservation. Accessed 19 Oct 2013.

  12. Brown KV, Clasper JC. The changing pattern of amputations. J R Army Med Corps. 2013;159(4):300–3.

    Article  PubMed  Google Scholar 

  13. Herard P, Boillot F. Amputation in emergency situations: indications, techniques and Medecins Sans Frontieres France’s experience in Haiti. Int Orthop. 2012;36(10):1979–81.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Knowlton LM, Gosney JE, Chackungal S, et al. Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies: report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict. Prehosp Disaster Med. 2011;26(6):438–48.

    Article  PubMed  Google Scholar 

  15. Sivathasan N, Chatterjee SS, Jain A. The Krukenberg procedure revisited. J Hand Surg Eur Vol. 2011;36(6):514–5.

    Article  PubMed  Google Scholar 

  16. Awais SM, Dar UZ, Saeed A. Amputations of limbs during the 2005 earthquake in Pakistan: a firsthand experience of the author. Int Orthop. 2012;36(11):2323–6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Le Feuvre P, Aldington D. Know pain know gain: proposing a treatment approach for phantom limb pain. J R Army Med Corps. 2013;160(1):16–21. doi:10.1136/jramc-2013-000141.

    Article  PubMed  Google Scholar 

  18. Hamdan TA. Psychiatric aspects of orthopaedics. J Am Acad Orthop Surg. 2008;16(1):41–6. Review.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Richard A. Gosselin MD, MSc, MPH, FRCS(C) .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Gosselin, R.A. (2016). Amputations. In: Robinson, J. (eds) Orthopaedic Trauma in the Austere Environment. Springer, Cham. https://doi.org/10.1007/978-3-319-29122-2_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29122-2_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29120-8

  • Online ISBN: 978-3-319-29122-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics