Amputation Principles and Targeted Muscle Reinnervation

Abstract

Amputation of an extremity is a common procedure performed for a variety of indications. For lower extremity amputations, certain co-morbid states (peripheral vascular disease, diabetes, etc.), trauma, oncology, and congenital deformities all contribute patients who may require amputation for medical or functional needs. Amputation can be performed at varying levels based on the patient’s need, including partial foot amputation, below-knee or above-knee amputation, or hip disarticulation. Regardless of the reason and site of amputation, there are a set of common principles of amputation that can aid in achieving the best functional outcome for the residual limb [1]. Figure 16.1 summarizes the most common levels of amputation and the most common associated motor nerve targets at each level.