COMMON CAUSES OF AMPUTATIONS
Neurological and Vascular disorders
Peripheral vascular disease is the most common cause of amputation and can be due to various conditions affecting the vascular and neurologic conditions. Vascular insufficiency, a term used to describe poor circulation in a certain part of the body is a strong indication that a patient may be at risk of having an amputation done in the future. Once a person does not have sufficient circulation to a limb, he is at an increased risk for nonhealing wound that ultimately result in amputation.
Diabetes is one of the main conditions in this group that result in amputation, but the amputation is most often more like due to poor management of the condition. Many diabetics are at an increased risk of amputation due to reduced sensation in their feet as well as poor circulation. Most diabetic amputations occur due to a small blister that has formed on a toe and that has not healed, resulting in necrosis and thus leaving amputation as the only option. The aim of the amputation is to find the level of the limb where the circulatory system is still healthy, any amputation lower than that level could resulting in a non-healing wound which would eventually end being a revision amputation.
Trauma amputations are second most common and are usually due to motor vehicle accidents or work-related accidents but can be due to any event that results in severe damage to a limb, either being amputated during the accident or needing to be amputated by a trauma surgeon due to the severity of the injury. Traumatic amputations are most common in younger people and is only performed if all other options such as replantation of the limb has been ruled out. What sets this type of amputation apart is the emotional trauma it causes. Most other types of amputations give the patient a controlled environment to accept the fact that an amputation needs to be done and usually a patient must have pre-amputation meetings with various health care professional. Patients who have suffered a traumatic amputation tend to struggle with a lot of emotional and psychological stress during their rehabilitation.
The most common cancer which requires amputation is osteosarcoma, this is because the tumour forms in the bone and in most cases, there are very few alternative treatment options. This type of cancer is mostly seen between late childhood and early young adult year. Osteosarcoma tends to appear at the epiphysis (close to the ends) of long bones during times of rapid growth. Children with osteosarcoma have a higher risk of suffering from regular fractures. Although an amputation is sometime unavoidable, with modern technology the amount of osteosarcoma amputation has greatly reduced due to early intervention with chemotherapy and radiation therapy.
Congenital amputations come in various forms, such as either a baby is born without a limb due to complications in the womb or a baby is born with an underdeveloped or malformed limb also due to similar complications. These conditions can be placed into these 6 categories: Failure of formation of parts, Failure of differentiation or separation of parts, duplication of parts, skeletal overgrowth, amniotic band syndrome and generalised skeletal abnormalities.
In many of these cases the parents would opt to have the deformed or underdeveloped limb amputated. Children adapt very well to prosthetic use and that is why it is better to have the amputation done at a younger age.