If you understand the amputation process, how it might affect your life, and who you can look to for assistance, it can make all the difference to your future quality of life. Read on to find out more and to see what options are available to you.
What is leg amputation?
Amputation is the full or partial removal of a limb. Our legs consist of a complex system of bones, joints, ligaments, and soft tissue. In simple terms the leg can be divided into sections connected by joints namely:
- The hip joint
- The upper leg
- The knee joint
- The lower leg
- The ankle joint
- The foot
Movement depends on co-ordination between the hip, knee and ankle joints as well the foot.
Injuries to any part of a leg can result in the loss of the entire leg or one or more sections for example a below knee or below ankle amputation. The higher the point of the amputation the more complicated any replacement prosthetic will be. For a below knee amputation the prosthetic needs to incorporate an ankle joint whereas an above knee amputation requires both ankle and knee joints, the movement of which must be co-ordinated.
The different types of leg amputation include, Hip amputation - Disarticulation or hemipelvectomy is the most dramatic type of leg amputation. It involves the removal of the whole leg. As such, it is one of the most demanding and invasive surgical amputation procedures from a technical standpoint.
Above-knee amputation – or transfemoral amputations – is a more common surgical procedure when damage to the leg is caused by trauma or disease. In some cases, it is done to “save the leg” if the limb below the knee becomes infected e.g., if a fracture does not heal.
Below-knee amputation - A transtibial amputation is where a section of the leg above the ankle, but below the knee joint, is removed. The aim will be to keep as much healthy bone, skin, blood vessel and nerve tissue as possible. Unlike a transfemoral amputation, the amputee still has the knee joint. This means they will have greater flexibility than someone who has an above-knee amputation.
Foot amputation - there are number of different types of foot amputation, which include:
- Syme’s amputation: The removal of the foot at the level of the ankle. For the individual, it ultimately means the whole foot is removed – but the lower leg remains intact.
- Chopart’s amputation: A partial foot amputation, which involves the removal of the fore and midfoot. The heel, however, will remain.
- Lisfranc amputation: This type is also called trans-metatarsal amputation, and it involves the removal of the forefoot. While the toes are removed, most of the foot will remain.
In rare cases, someone may suffer a bilateral amputation. This is where both lower limbs are affected – not just one. An example of this is when both legs are amputated above the knee.
No matter what type or level of amputation you experience, it can have a significant impact on your life.
What can cause a leg amputation?
Just like any amputation, the loss of all or part of a leg is never a first-choice option.
An amputation may occur because of a traumatic injury or following surgical intervention.
Accidents are the most common cause of traumatic amputations and can involve the immediate separation of a leg or parts of it. The level of the amputation suffered in an accident may not be the final extent of the amputation. If the amputee suffers tissue damage this may lead to further removal by surgery. In some cases, the accident may not result in an immediate amputation. There may be an attempt to save the leg or parts of it, but if the injuries do not heal or are so extensive the part affected cannot be saved this may result in an early and sometimes lifesaving post-accident amputation.
The most common causes of a traumatic hand amputation include:
- an accident at work, usually involving machinery
- or a road traffic accident
- An accident involving defective household products
A traumatic amputation can have serious consequences in the short term. It comes with the risk of shock, blood loss or infection. But rapid medical treatment can ensure it doesn’t end up being fatal.
Non traumatic causes of amputation include illnesses and medical conditions such as: diabetes; meningitis; compartment syndrome; delays in diagnosing vascular disease or cancer; post-operative blood clots; and infections.
Individuals who have been injured in accidents but initially do not require an amputation because there was hope the leg or part of it could be saved, may, as a last resort after many years of treatment and surgical interventions, opt for a voluntary amputation. This may be to relieve chronic pain, reduce the risk of infection or because nerve and ligaments damage has destroyed or severely impaired functionality.
For more information read our article about the common causes of amputation.
What does leg amputation surgery involve?
A surgical leg amputation will be done under general anaesthetic (where you are unconscious) or with an epidural (which numbs the lower half of the body). While leg amputation is mainly about removing all or part of a limb, there are extra procedures used to improve the function of the remaining section of the leg limb that helps to reduce later stump and skin complications.
In an elective above-knee leg amputation, for example, the skill of the surgeon is in cutting your femur above the knee joint. The aim is to leave enough of the soft tissue and allow the skin flaps to cover the end of the remaining part of the bone. This creates a ‘stump’ that will fit the socket of a prosthesis – if one is to be fitted after the operation.
If an amputation is an elective procedure, the surgeon and the prosthetist need to work together before the operation to ensure the best result is achieved with the stump socket fitting.
Of course, your surgical options are more limited when traumatic amputation occurs at the time of the accident. The focus at this time will around saving as much un-damaged tissue as possible.
Leg amputation: How common is it?
The number of people rebuilding their life after leg amputation is relatively small when compared to the overall population. Data from NHS hospitals in England shows leg amputation statistics for finished consultant episodes (FCE), which is a continuous period of admitted patient care under one consultant and within one healthcare provider. The figures reveal a fairly even split between the number of finished consultant episodes for above-knee amputations (2,252) and below-knee amputations (2,452).
Life after leg amputation: What is the impact?
It can be really hard for you and your loved ones to adjust to life after a leg amputation because the loss of part of a leg, all of a leg or both legs scan affect all areas of our lives, such as:
- Balance and movement
- The ability to work
- Emotional wellbeing
- Sport and exercise
It is still possible to enjoy a high quality of life after leg amputation, but there will be a period of adjustment and rehabilitation. We partner with world-leading specialists in prosthetics, care, physiotherapy, rehabilitation and accommodation. This places us in a good position to help you during this period of adjustment by ensuring you are aware of the latest medical and technological advances so that you can make choices to improve all aspects of your new life. We will also put you in touch with the right people so that we can build a support network tailored to your exact needs.
We can also provide guidance when it comes to deciding whether to engage the services of a Case Manager to help with care and assistance and to understand what you need in the way of aids and equipment and your entitlement to state benefits.
Are there any risks with a leg amputation?
No operation is without risk. If your amputated leg is the result of surgery that is elective or the last-resort solution, there may be pain or bleeding after the operation that will soon recover. You could also experience “phantom limb” – a condition where sensation can still be felt in your leg, even after it is removed.
You may also need to deal with:
- Ongoing emotional distress and feelings of loss
- Pain and soreness in the ‘stump’
- The possible need for revision surgery
We can put you in touch with experts and support groups to help you understand, prepare and overcome these risks – and longer-term concerns such as slow healing, infection or even conditions like deep vein thrombosis where you retain parts of your leg.
How can Shoosmiths help?
No-one should have to come to terms with a leg amputation on their own. Our team of amputation claims specialists have many years of experience dealing with amputation claims. If your amputation was caused by either an accident that was not your fault, or the negligent treatment you received from a health professional, we can investigate your circumstances to establish whether you can make a claim for compensation. We can also assist with your rehabilitation and recovery. Any compensation you receive will help cover the cost of any care, ongoing treatment, lost income or even an arm replacement prosthetic.
Talk to us for free and in confidence. Call 0808 301 7915 today or send us a message.
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2023