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 transfemoral amputation work?

Common reasons for transfemoral amputation are severe accidents, circulatory disorders due to vascular diseases or tumors in the leg. Amputation is the last measure and is only performed if the tissue in the leg can no longer be preserved by other measures. In a transfemoral amputation, the femur is cut off as close as possible above the knee. The loss of the knee joint results in a drastic restriction of mobility. To restore mobility, care is taken during surgery to leave the stump of the femur as long as possible so that it can be used as a stable anchor for a prosthesis. To ensure that the residual limb can bear weight and that no pressure points are created by the remaining bone, it is important to leave a sufficient soft tissue mantle consisting of muscles, tissue and skin and to cover the cut bone with it.

How is a prosthesis fitted?

A transfemoral amputation is a drastic experience for those affected. In addition to the psychological stress, the lost mobility and the handling of the residual limb are a daily challenge. In addition to rehabilitation after successful healing of the residual limb, further treatment includes the fitting of a prosthesis. In this regard, we address the individual needs and unique situation of each patient in a professional consultation. Until the final prosthetic fitting, we work together to find a solution for the transitional period. Transitional prostheses, forearm crutches and wheelchairs can be useful for this purpose.

Young woman prosthetic leg hiking with friends in nature.

Does health insurance cover a transfemoral prosthesis?

All persons with statutory insurance who require a prosthesis are also entitled to a prosthesis according to SGB V. After we have submitted a cost estimate to your respective insurance company and it has been approved, the fitting will begin. If you are not exempt from co-payment, you only have to pay a €10 prescription fee.

Private insurance companies usually cover the treatment 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, 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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