Understanding Limb Loss and Amputation

There are a lot of reasons someone might lose a limb or have to undergo an amputation. For example, car accidents or serious construction accidents can lead to the loss of a limb. There are also diseases and other reasons workers and other individuals may lose a limb or require an amputation. 

When someone loses a limb, it changes their entire life, impacts their functionality, and also affects their mental health. 

The following are some of the things to know, whether it’s something you’re personally going through or you’re supporting a loved one who is. 

Limb Loss Statistics

According to estimates, there are almost two million Americans who are living with limb loss. 

The main causes are vascular disease, which includes diabetes and peripheral arterial disease, trauma, and cancer. 

There are around 185,000 amputations that occur in the U.S. every year. Nearly half of the people who undergo an amputation because of vascular disease will die within five years, which is a higher five-year mortality rate than for colon, breast, and prostate cancers. 

Of people with diabetes who undergo lower extremity amputations, up to 55% will need their second leg amputated within two to three years. 

A traumatic amputation can occur because of a car accident, industrial accident, occupational injury, or an injury from combat. Traumatic injuries account for around 45% of total amputations. 

If someone goes through a traumatic injury, their body part can be torn away or cut off, or so badly damaged from burns or a crush injury that it can’t be saved. 

Also, if there’s tissue destruction, disease, or infection affecting a body part in a way that’s endangering someone’s life or it isn’t possible to repair it, surgical amputation may be needed. 

A disease or traumatic injury can stop blood flow to a body part for so long that it causes tissue death, leading to the need for an amputation. 

Causes of Amputation

We touched briefly on some of the causes of amputation above but went into more detail about them below. 

  • Vascular disease: Overall, peripheral vascular disease is the most common cause of limb loss. Peripheral vascular disease is also known as peripheral artery disease or lower extremely occlusive disease. This condition affects the peripheral vascular system, and primarily the arteries. Atherosclerosis is the process of peripheral artery disease. Peripheral vascular disease is considered a type of cardiovascular disease with a gradual onset. It’s progressive, and it tends to become more common in older people.  
  • Diabetes: Amputation is one of the possible major complications of diabetes. When people have diabetes, their doctor will often advise them to check their feet daily. Diabetes can lead to peripheral artery disease, causing the blood vessels to narrow, reducing blood flow to the legs and feet. It can also cause nerve damage, which is peripheral neuropathy. When you have peripheral neuropathy, you might not be able to feel pain, so you could possibly not realize you have an ulcer or wound on your feet. You might keep putting pressure on the area that’s affected, so it can cause infection. When you have reduced blood flow, it slows the healing of wounds. Your wound may not heal at all, and tissue damage or death can occur. The infection may spread to the bone. If the infection can’t be stopped, or the damage can’t be repaired, it may lead to the need for an amputation. In people with diabetes, the most common amputations are the lower legs, feet, and toes. 
  • Cancer: Removing a limb or a hand or foot may be done to prevent the spread of certain types of cancers, but this is rare. Sarcomas can affect bone and soft tissues in the limbs, so if it’s too aggressive or large to be removed, or if it extends into the nerves, amputation might be needed. If someone has advanced cancer that affects their upper leg, they may need to have a procedure called disarticulation. With disarticulation, the femur is removed from the pelvis. 
  • Severe infection: Severe sepsis is also known as blood poisoning or septicemia. When drug-resistant bacteria overwhelm the body and spread into the bloodstream, it can occur. Sepsis can affect the flow of blood and cause tissue death. An amputation may be needed to save someone’s life. 

Complications After Amputation

After someone undergoes an amputation, no matter the reason, phantom pain and limb sensations are almost universal. Doctors don’t fully know why this is but think it could be due to the remaining nerve connections in the brain and spinal cord that can remember the body part. 

Patients who lose a leg or foot are at risk of falling, especially if they try to get out of bed and they forget about the amputation. The falls can be serious, but rehabilitative therapy can help. 

There are many emotional and mental health effects of amputation or limb loss that can occur too. 

When someone loses a limb, it affects their body image, sensation, and function. The psychological reactions someone goes through can vary depending on many factors. 

More than 30% of amputees struggle with depression. Social isolation, increased dependence, and decreased self-esteem are often seen in the short- and long-term follow-up after an amputation. 

Someone’s immediate reaction following an amputation can depend on whether it was planned and occurred because of a chronic medical condition or if it was the result of a sudden trauma or infection. 

When someone finds out they may need an amputation, anxiety often occurs with depression. 

Post-traumatic stress disorder or PTSD seems more common in people who experience an amputation because of combat, a burn, accidental injury, or a suicide attempt. Following a chronic illness requiring an amputation, PTSD is pretty rare. 

If someone experiences a traumatic injury that leads to the loss of a limb, there may be options for them to pursue damages if someone else was responsible. For example, following an occupational injury or a car accident, a person may be able to pursue economic and also non-economic damages from the at-fault party for their injuries.

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