What is an amputation?

Amputation is the technical term for the separation of a body part. This may be planned surgical or traumatic, resulting from an accident. There are many reasons for surgical amputation, but it is usually the last resort and is not performed lightly. The decision to amputate a body part is usually made when tissue is so damaged that it dies, increasing the risk of life-threatening infections. This occurs, for example, in vascular diseases, bacterial infections, advanced diabetes mellitus, cancer or after serious accidents. In principle, the aim is to amputate as little as possible and to preserve the function of the affected body part as far as possible.

How does a toe amputation work?

Toe amputation involves surgical removal of single or multiple toes. Common causes include diabetes mellitus, vascular disease, local infection, frostbite, and deformity. The procedure is carefully planned using various imaging techniques to ensure that the remaining stump has adequate blood supply. During surgery, the bones of the affected limb are cut and removed, and the resulting wound is covered with protruding skin.

What are the options after a toe amputation?

The removal of a single little toe usually does not represent a serious change in stability during walking and standing. However, the reasons for amputation are often systemic diseases of the vessels, so that further amputations are often necessary in the course. The impact on the aesthetics of the foot and the psychological burden of an amputation should also not be ignored. Depending on whether only the toe is amputated or the metatarsal bone is also removed (radiation amputation), it may be necessary to use a prosthesis. This should help the affected person to restore the original stability and thus ensure independent mobility.

How is a prosthesis fitted?

After a toe amputation, complete healing of the residual limb must be waited for before fitting the prosthesis. Basically, there is a choice of temporary and definitive prostheses. We take the time in a detailed consultation to find an individually suitable solution. The primary goal is to restore the lost stability and mobility and thus significantly increase the quality of life.

In addition to the prosthesis, other aids such as a brace or cane can be considered for safety when walking and standing. Here, too, we are happy to take the time to provide detailed advice on the options.

What complications can occur after an amputation?

In addition to general surgical risks such as wound healing disorders, bleeding and infections, so-called phantom sensations can occur after amputations. These are sensations such as burning, cold or warm sensations and even stabbing pain in the area of the amputated limb. This phenomenon can be prevented by early local anesthesia, for example, during a toe amputation. In treatment, mirror therapy, transcutaneous nerve stimulation, drug therapy and biofeedback have proven to be particularly effective.

[1] Griffin, K.J., Rashid, T.S., Bailey, M.A., Bird, S.A., Bridge, K., Scott, J.D.A., 2012. toe amputation: a predictor of future limb loss? J Diabetes Complications 26, 251-254. https://doi.org/10.1016/j.jdiacomp.2012.03.003

[2] Isaacs-Itua, A., Sedki, I., 2018. management of lower limb amputations. Br J Hosp Med (Lond) 79, 205-210. https://doi.org/10.12968/hmed.2018.79.4.205

[3] Kaur, A., Guan, Y., 2018. phantom limb pain: A literature review. Chin J Traumatol 21, 366-368. https://doi.org/10.1016/j.cjtee.2018.04.006

[4] Roll, C., Forray, M., Kinner, B., 2016. amputation and disarticulation of the lesser toes. Oper Orthop Traumatol 28, 345-351. https://doi.org/10.1007/s00064-016-0451-y

[5] Anvil - pain therapy

https://next.amboss.com/de/article/xN0EWg#Zd9b5808a36be5c17e92b209045003b83 (aufgerufen am 30.07.2022)

[6] Anvil - Operative procedures in trauma surgery/orthopedics

https://next.amboss.com/de/article/vl0AAT?q=amputation#Zc1f40bd23bcce41c743d098eaa88dfea (accessed 07/30/2022)

[7] Anvil - Perioperative management

https://next.amboss.com/de/article/550ikg (accessed 07/30/2022)

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