Amputation and prosthetic limbs
}January 4, 2022
jDr.. Muhannad Al-Khatib

Amputation and prosthetic limbs

}January 4, 2022
jDr.. Muhannad Al-Khatib

Amputation and prosthetic limbs

Table of Contents

    The amputation process is known as the removal of a limb or part of the limb for a medical reason. The patient may face psychological and physical difficulties in adapting to his life after the amputation and the installation of a prosthetic limb in Turkey.

    Why is amputation resorted to?

    Amputation is used as a last resort treatment when no other methods are available to treat one of the following reasons:
    • Poor blood flow towards the limb, causing the limb to die because it is not supplied with enough oxygen
    • Complications of diabetes are one of the most common causes of amputation, especially foot amputation. The reason behind this is diabetic arteropathy, which causes poor blood flow, in addition to the neuropathy associated with diabetes, which causes poor sense of the patient's foot injuries and ulcers.
    • Severe infections that may spread to the rest of the body if the limb is not amputated are like gangrene
    • Severe trauma such as car accidents or burns
    • some Malignant tumors Spread in the muscle tissue and bones of the extremity
    • Peripheral arterial disease (PAD), which causes poor blood flow through the arteries to the extremities
    • Forest bite also causes poor blood flow and death on the tip
    • Large wounds and ulcers that do not heal and do not heal
    • Limb deformities that impair movement and function

    Types of amputation in Turkey

    The amputation may take place at the level of the upper limb, the lower limb, or both, and the amputation process may be limited to one of the parts of the limbs (hand, foot, leg, forearm, fingers).
     
    In fact, the amputation that takes place at the level of the lower extremity is much more common than that which takes place at the level of the upper extremity.
    According to a study conducted in the USA 3% only of the amputations were performed at the level of the upper extremity.
     
    Lower extremity amputation patterns are:
    • Foot or toe amputation
    • Lower limb amputation below ankle level. An amputation of the foot from the ankle joint down.
    • Below-knee amputation The lower limb is amputated just below the knee joint. This is the most common type of amputation performed according to for studies.
    • Knee disarticulation is the amputation of the lower end of the knee joint.
    • Above-knee amputation In this style, the lower limb is amputated above the knee joint.
    • Hip disarticulation The entire lower end of the hip joint is amputated.
    • Trans-pelvic disarticulation. This method involves amputating the entire lower extremity while removing part of the pelvic bone.
      Lower limb amputation levels

      Lower limb amputation levels

    The types of upper extremity amputation are:
    • Amputation at the level of the hand or fingers
    • amputation at the level of the wrist disarticulation
    • Below-the-elbow amputation, i.e. amputation is performed directly below the elbow level.
    • Elbow disarticulation, the lower part of the arm is amputated and separated from the upper part, that is, the ulna and radius are amputated.
    • Above-elbow amputation, the lower section of the arm is amputated in addition to the elbow and part of the upper arm where the incision is made through the humerus.
    • Shoulder disarticulation The arm is completely amputated at the shoulder level.
    • Forequarter amputation In this style, the entire upper limb is amputated, as well as part of the shoulder.
      Upper extremity amputation levels

      Upper extremity amputation levels

    Before having an amputation in Turkey

    Amputation may be performed as an emergency (eg in car accidents or burns). Or it may be performed as a non-emergency scheduled surgery (as in the case of peripheral arterial disease - sepsis - cancer).
     
    In the event that it is decided to perform the amputation in a non-emergency manner, the doctor examines the patient in detail to ensure that the patient is able to undergo this operation.
    In addition to the respiratory system, the health of the cardiovascular system is examined. General tests are also ordered and the electrolyte distribution in the body is monitored.
     
    The doctor also resorts to examining the healthy counterpart, where he is assured of the safety of the counterpart and its readiness to bear the burden that will be added to it as a result of the amputation of the other limb.
    After making sure of the patient’s readiness, the orthopedic surgeon explains the method of amputation that suits the patient’s condition, where the healthy tissue is preserved as much as possible, in addition to performing the operation in a way that enables the patient to install an alternative prosthesis in that area.
     
    The psychological aspect should be given special importance, as permanently losing a limb is not easy for the patient and may have severe psychological effects that affect the patient's life after the operation.
     
     Before the amputation is performed, the patient is introduced to the physical therapist who will provide assistance to the patient after the amputation, in addition to the prosthetist, who advises the patient in choosing and installing the prosthetic limbs that suit his condition.

    During the amputation process 

    The main goal of amputation is to remove the affected tissue and preserve healthy tissue as much as possible.
     
    When it is decided to perform surgery to amputate a limb, the doctors study the possible results of the operation on the patient’s ability to move and feel the limb in addition to the aesthetic results.
     
    The patient is sedated either by general anesthesia or by spinal anesthesia (Anesthesia for the lower part of the body), after which a surgical incision is made and the damaged tissue is removed by amputating the affected part of the limb with a surgical scalpel.
    The surgeon smooths the uneven bone areas, closes the vessels and nerves tightly, and also cuts the muscles and makes them optimally in preparation for the installation of the prosthesis in its place, after which the wound site is dressed with a sterile bandage.
     

    The amputation process takes about 45 to 90 minutes in the absence of complications that make the process long.

    The patient’s stay in the hospital after the operation depends on the type of amputation that was performed, but often the patient stays about 4 to 14 days after the operation in order to evaluate the patient and make sure that there are no complications or complications resulting from the surgery.

    Amputation

    Amputation

    Recovery after amputation

    The first day after the operation is the most difficult day for the patient. What yesterday were just hypotheses became a reality that the patient must live with for the rest of his life. The loss of a limb is somewhat similar to the loss of a close family member.
     
    The hospital staff monitors the wound resulting from the amputation surgery, and the dressings are changed from time to time.
    Pain medication and sedatives are prescribed after the operation, and antibiotics may be prescribed to prevent infection.
    After the operation, the patient is provided with oxygen through the mask, and a urinary catheter is also placed for the patient to avoid the need to go to the bathroom so that the patient remains stable and the wound is healed.
     
    After the operation, some patients suffer from a phenomenon called phantom pain, meaning that pain or a sensation is felt in the amputated limb that is not present in the first place.
    This phenomenon is common among patients after the amputation for a reason that is not fully understood. Some believe that the cause of this phenomenon is due to psychological reasons, while some doctors explained the reason for this phenomenon by the random mixed response of the brain after the amputation, where the nerves responsible for the amputated limb are stimulated.
     
    The patient begins to receive the physical treatment A few days after the amputation in order to move the body and limbs and prevent blood stasis as a result of prolonged stay in bed during recovery to ensure wound healing.
    Physiotherapy continues after the wound has healed. The physical therapist helps the patient maintain normal range of motion in amputation sites, in addition to stretching exercises.
     
    The physical therapist also gives instructions and advice to the patient after the amputation is performed. Physical therapy is a lengthy rehabilitation process for amputations that may take a number of months and may reach years.
     
     The wound is completely healed after the operation about 4 to 8 weeks. There are factors that delay wound healing, such as the presence of chronic diseases such as diabetes or smoking.
    The prosthesis can be fitted after the wound has healed well.
    The prosthetic technician works side by side with the physical therapist in the rehabilitation period after the amputation.
     
    The recovery and rehabilitation phase may take a long time until the patient gets used to his new life. The rehabilitation team consists of a physical therapist and a surgeon in addition to a psychiatrist who helps the patient during the recovery period, and the medical staff responsible for installing prosthetics may join the rehabilitation team in case the procedure is planned Limb fitting after amputation.

    Amputation risks 

    No surgical procedure is completely free from risks. The amputation process may be associated with complications resulting either from the surgery or because of the effect of the amputation of the limb on the body. We mention some complications:
    • Infection at the site of the wound
    • Delayed wound healing and healing
    • Venous thrombosis (DVT) due to blood stasis at the site of a limb amputation
    • Pneumonia (an infection of the lung)
    • phantom pain in amputated limb
    • heart problems Like a sudden stroke

    An overview of the prosthetics

    prosthetics

    prosthetics

    Prosthetics are devices that work to some extent to replace amputated limbs in terms of form and function. Not everyone who has undergone amputation is able to install artificial limbs, as there are a number of factors that play a role in this.
     
    The presence of sufficient soft tissue in order to place the prosthesis is important in addition to the patient’s general health condition. The prosthesis installation requires the patient to undergo prolonged physiotherapy sessions. If the patient is unable to do so, it is preferable not to place the prosthesis.
     
    The decision to install prosthetic limbs also depends on the type of amputation that was performed. For example, amputation that is carried out at the level below the knee is a good candidate for the placement of artificial limbs, unlike amputation that is carried out above the level of the knee, where the presence of artificial limbs The knee joint It facilitates the installation of prosthetic limbs in that area.
     
    The decision to install the prosthesis also depends on the reason that led to the amputation. The patient’s motor activity plays a role in this. The patient with little physical activity will find it more difficult to deal with the prosthesis compared to the athlete who was amputated for some reason.
     
    The types of prosthetics available vary, there are prosthetics for the hand and fingers, prosthetics above the knee, and prosthetics for below-knee amputations.
    The process of rehabilitating the prosthetic limb and adapting to it may take a long period of time until the person gets used to using the prosthesis well.

    Why should I choose treatment in Turkey?

    Recently, Turkey has become one of the leading countries in the field of medical tourism in the world.
    The reason for this is due to the presence of advanced medical centers that provide appropriate treatment by the most skilled doctors and the latest medical devices at a low cost.
    and stay Bimaristan Center Medical is your first choice For treatment in Turkey.
    We guide you to the best expert specialists in all departments.
    We facilitate the language of communication between you and everyone through specialized Arab doctors who will help you communicate with your doctor.
    We help you in securing the appropriate treatment and high-end service in the latest hospitals and the best medical operations centers in Turkey.
    We provide our services extensively and precisely.
    We accompany you step by step towards recovery.
    Free consultations around the clock.
    do not hesitate Contact usBimaristan, your family center in Turkey.
     

    The most important frequently asked questions about amputation in Turkey.

    When is an amputation performed for one of the parties?

    In some cases, doctors say that they have to perform an amputation on both sides for a medical reason. The reasons for amputation are:

     
    How is a limb amputation performed?

    In most cases, it is done under general anesthesia according to a complete planning by the doctor after the first examination of the patient

     

    How is amputation prevented?

    There are a number of factors that contribute to the prevention of amputation, and in some cases a medical intervention may be performed to save a diabetic leg from amputation.

     

    What are the effects of the amputation on the patient?

    There are many multiple effects associated with the amputation process, most of which are psychological related to the loss of the organ and differ from one patient to another.

    How long does leg amputation take in Turkey?

    A leg amputation operation in Turkey generally takes between one and a half and two hours.

    Why is the diabetic foot amputated with gangrene?

    Diabetic leg or foot is amputated because it is dead tissue that contains bacterial infections, but it does not move and spread and cause larger cell death, which leads to larger tissue pieces.

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