Limb loss refers to the partial or total loss of an arm or leg, commonly as a result of traumatic injury, congenital or acquired disease or infection.
In addition to the physical absence, limb loss is often accompanied by painful sensation from the area of the lost limb, known as phantom limb pain. Limb loss can also result in the formation of painful clusters of nerve tissue, known as nueroma, in the residual limb.
Patients may also experience a range of psychological issues, either as a result of the loss, or subsequent pain, including post-traumatic stress disorder, anxiety and depression, as well as specific concerns around self-image.
Limb loss can result from a wide range of causal factors, including:
Traumatic injury: including road traffic accidents and industrial accidents resulting in unsalvagable soft tissue, vascular and/or bone damage.
Vascular disease: conditions such as peripheral vascular disease can restrict blood flow to the extremities, limiting oxygen and nutrients and causing tissue death.
Tumour: amputation can prevent the growth of bone tumours or the spread of metastasised soft tissue cancers.
Infection: Severe and soft tissue infections (e.g., osteomyelitis, necrotizing faciitis) that have failed to respond to antibiotics or other surgical interventions may be treated by amputation.
Congenital conditions: where congenital deformities cannot be treated by other means, amputation may relieve pain and, with the use of prosthetics, restore function.
Limb loss, invariably, involves some level of surgical intervention. However, there are a range of non-surgical treatment options which can be used to support post-loss recovery and associated symptoms. These include:
Physiotherapy: intended to recover range of motion, mobility and muscle strength.
Pain management: non-opioid anaelgesics, anti-inflammatories and nerve pain medications such as gabapentin can help relieve neuropathic pain.
Psychological support: can be used to address depression, anxiety and post-traumatic stress disorder, and to support neccessary cognitive adjustment to the loss of the limb.
Prosthetics: advanced prosthetic devices, including osseointegrated implants, can significantly enhance mobility and improve quality of life following limb loss.
Any surgical treatment will be dictated by the level of limb loss, and the condition of the residual limb, as well as the presence or absence of adjunct symptoms. Surgical treatment options include:
Nerve surgery: both Targeted Muscle Reinnervation (TMR) and Regenerative Peripheral Nerve Interface (RPNI) can help to reduce nerve pain in the residual limb.
Revision: revision surgeries can be used to reshape or reconstruct the residual limb to improve appearance and prosthetic fit and comfort.
Osseointegration involves the implantation of a titanium implant within the residual bone to provide a connection for an external prosthesis, thereby avoiding socket-related problems such as skin breakdown and neuroma formation.
For detailed information on limb amputation, visit our Limb Reconstruction page.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
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Professor Dr Munjed Al Muderis is an orthopaedic surgeon specialising in osseointegration, hip, knee and trauma surgery. He is a clinical professor at Macquarie University and The Australian School Of Advanced Medicine, a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group.