Amputation is the general term describing a condition of disability resulting from the deliberate surgical removal of a part of the body, a limb, or part of a limb (Bowker & Michael, 1992). Limb loss can be a congenital condition, the result of traumatic injury, or a surgical procedure to treat disease (Clawson, 2009). Clawson posits that the majority of amputations in the United States are the result of vascular disease caused by diabetes (p. 393). In cases of traumatic amputation, adjustment and adaptation is more difficult than for people who have had time to prepare, such as may occur with diabetes. Amputations may be performed at any level in the upper extremities such as the digits, the hand, or the arm, or in the lower extremities such as the toes, the foot, or the leg. Amputation is an emotional, life-altering occurrence that most often results from either disease or trauma (Hanley et al., 2004). Appropriate rehabilitation is a vital element to helping people with lower limb amputation learn to walk and function again and live high quality lives.
In the United States, the majority of amputations are performed in order to treat complications of peripheral vascular disease; the greater numbers involve the lower limbs (Clawson, 2009). According to Bowker and Michael (1992), disease is the most frequent reason for amputation in adults age 50 or older, while trauma is the usual cause of amputation in younger individuals. Marshall and Stansby (2008) include malignant tumor, uncontrollable acute or chronic infection, congenital deformity, ‘useless’ limb (usually due to neurological injury) and chronic pain as other common reasons for amputation (p.21). Amputation can be either major (majority of the limb removed) or minor.
Amputation is a considerable surgery that can either be preplanned or performed on an emergency basis. It is usually performed under a general or regional block anesthetic, although a local anesthetic is sometimes used for finger or toe amputations (Bowker and Michael, 1992). Because of ever improving surgical techniques, postoperative rehabilitation, and prosthetic design most individuals who undergo amputation return to high levels of functioning after reconstruction and rehabilitation. Marshall and Stansby (2008) posit that partial or full loss of an extremity invariably produces some degree of permanent disability, although persons who go through lower extremity amputation are likely to regain mobility. Prostheses typically provide limited return of normal function in the case of upper extremity amputation. However, amputations of fingers and thumbs most often decrease the ability to accomplish tasks requiring manual dexterity.
Complications of amputation include edema (swelling of tissues), contracture (abnormal, often permanent shortening of muscle tissue), infection, and pain (Seymour as cited in Clawson, 2009, p. 394). A certain amount of edema at the stump (the distal end of a post-amputation limb)...