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Amputation is a word that no one wants to think about. However, it is a fact of life for millions of people. Amputation of the foot usually results from the effects of a disease of the blood vessels in one's lower limb. Such blood vessel disorders can cause hardening of the arteries, poor circulation, or large clots in the arteries which cannot be removed. Other causes of foot amputation include injury, infection, cancer, or birth defects. Amputation will only be used by a surgeon as a last resort if it seems that circulation cannot be improved in any other way, or if the risk of the development of gangrene and/or severe pain cannot be avoided.
During amputation, either parts of the foot, such as the toes, or the entire foot may be removed. If one's entire foot must be surgically amputated, this usually occurs just above the knee or just below the knee, depending upon the extent of the damage to the foot and/or lower limb and the possibility of fitting an artificial prosthesis after the amputation. The most common preferred amputation is below the knee, in order to preserve the knee joint and make post-amputation prosthetic fitting and re-learning to walk much easier.
Complications of amputation include risk of blood clots and infection, and problems in wound healing. This can be exacerbated by poor circulation, which is why a diabetic's blood sugar will be closely monitored following amputation to assist in proper healing. If amputation was done below the knee but proper healing is not possible post-amputation, the amputation will have to be performed again, this time above the knee.
Following amputation, the patient can expect the wound to heal within two weeks.
Although some pain is involved, many amputees complain of a phenomenon described as phantom pain. In this situation, the amputee “feels” pain in the part of the foot or leg that has been removed. Phantom pain is more common in situations in which severe pain was present in the foot or leg prior to amputation. Usually phantom pain will disappear after a certain amount of time following the surgery.
After the wound is totally healed, prosthetic fitting will begin. First, measurements will be taken to ensure proper fit of a new prosthesis, to make sure patients will be balanced and that muscles will not be strained when learning to walk again. Learning to walk again with a prosthesis can be quite difficult and may take a long time with much physical therapy and practice.
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