What is an amputation?
Amputation is the technical term for the removal of a body part. This can occur surgically as a planned procedure or traumatically through an accident. The reasons for a surgical amputation are varied, but it is generally considered a last resort and is not undertaken lightly. The decision to amputate a body part is usually made when tissue is so damaged that it dies, thereby increasing the risk of life-threatening infections. This can occur, for example, in vascular diseases, bacterial infections, advanced diabetes mellitus, cancer, or after severe accidents. In general, the aim is to amputate as little as possible and to largely preserve the function of the affected body part.
How is a thigh amputation performed?
Common reasons for a thigh amputation include severe accidents, circulatory disorders due to vascular diseases, or tumors in the leg area. Amputation is the last resort and is only performed when the tissue in the leg can no longer be preserved by other measures. During a thigh amputation, the femur is cut as close to the knee as possible. The loss of the knee joint leads to a significant restriction in mobility. To restore mobility, care is taken during surgery to leave the thigh stump as long as possible to use it as a stable anchor for a prosthesis. It is important to ensure that the stump is load-bearing and that there are no pressure points from the remaining bone, by leaving a sufficient soft tissue cover, consisting of muscles, tissue, and skin, to cover the severed bone.
How is a prosthesis fitted?
A thigh amputation is a profound experience for those affected. In addition to the psychological burden, the loss of mobility and dealing with the stump pose daily challenges. Post-operative care includes rehabilitation after successful healing of the stump and fitting with a prosthesis. In this regard, we engage in a professional consultation to address the individual needs and unique situation of each patient. Until the final prosthesis is provided, we find a solution for the interim period. For this purpose, temporary prostheses, forearm crutches, and wheelchairs can be useful.

Does health insurance cover a thigh prosthesis?
All legally insured individuals who need a prosthesis are also entitled to one according to SGB V. After we have submitted a cost estimate to your respective insurance company and it has been approved, provision begins. Unless you are exempt from co-payments, you only need to pay a statutory prescription fee of 10€.
Private insurances usually cover the provision as well. However, in this case, you must submit the cost estimate to your respective insurance company.
What complications can occur after an amputation?
In addition to general surgical risks such as wound healing disorders, bleeding, and infections, amputations can lead to so-called phantom sensations. These are sensory disturbances such as burning, cold or warmth, or stabbing pain in the area of the amputated limb. This phenomenon can be prevented by early local anesthesia, e.g., during a toe amputation. In treatment, mirror therapy, transcutaneous nerve stimulation, pharmacological therapy, and biofeedback have proven to be effective.
Bibliography
[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 und Exartikulation der Kleinzehen. Oper Orthop Traumatol 28, 345–351. https://doi.org/10.1007/s00064-016-0451-y
[5] Amboss – Pain Management
https://next.amboss.com/de/article/xN0EWg#Zd9b5808a36be5c17e92b209045003b83 (accessed on 30.07.2022)
[6] Amboss – Surgical Procedures in Trauma Surgery/Orthopedics
https://next.amboss.com/de/article/vl0AAT?q=amputation#Zc1f40bd23bcce41c743d098eaa88dfea (accessed on 30.07.2022)
[7] Amboss – Perioperative Management
https://next.amboss.com/de/article/550ikg (accessed on 30.07.2022)

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For a standard model, expect a statutory co-payment between €5 and a maximum of €10 per fitting. Additional costs may apply for premium fittings, depending on the model.
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