Causes of Upper Limb Amputation: What to do Afterwards
There are four main causes for limb loss/amputation: trauma, infection, cancer and congenital deficits. Each of these can be traumatic and may require the individual to seek psychological support which will help them gain a better quality of life.
Understanding the causes of amputation helps the prosthetist determine the most appropriate prosthesis to fit the patient's needs and support them during the process of learning how to function with it.
Traumatic amputations can be caused by motor and vehicle accidents, industrial accidents, construction accidents, fireworks or electrocution accidents, etc. This may lead to damaging or partially tearing off the fragment of the limb.
Nearly 1.2 million of Americans live with an amputation, about 22% of amputations are caused by trauma. Patients who have lost their limbs due to traumatic limb loss may deal with anxiety and depression but also with post-traumatic stress disorder (PTSD), which can cause panic attacks, flashbacks during the day or even nightmares reducing sleep.
Patients often have to deal with phantom pain. This type of pain affects 80% of all amputees, it refers to the feeling of pain in the residual limb or the sensation of the lost limb. The source of these pains is seen in damaged nerve bonds at the amputation site.
The level of pain experienced by the patient varies depending on the type of amputation, it can be short and temporary pain similar to stabbing or burning causing discomfort to the patient, but also chronic and excruciating at times.
Second most common reason for amputations are life-threatening infections.
Infection occurs when the patient has been exposed to burns, frostbite, wounds or the underlying disease has not been treated for a long time, which can cause partial or full upper limb amputation.
This can lead to gangrene or sepsis, over 1.6 million of amputations are annually performed in the United States, which 10% is caused by complications from sepsis.
Cancer is a disease that affects an increasing number of people. It is difficult to predict which type of cancer will be the reason for the amputation decision. However, osteosarcoma (bone cancer) is one of the leading causes of amputation due to cancer.
Elective amputation is a difficult decision to make. Surgeons and doctors are aware that amputation may be the only way to save the patient's life.
Osteosarcoma creates a tumor inside the bones which on X-ray might look like holes, and creates lumps under the skin. If diagnosed early and treated hopefully it can be stopped from growing and spreading throughout the body.
These amputations affect less than 2% of people and are needed only if tumors in bone or soft tissue do not respond to treatment.
The most common congenital deficits of the upper limbs are finger defects (contractures, curvatures, missing part of the phalanges, underdevelopment of the whole hand). In some situations, doctors often point to amputations and prosthetics as the most functional outcome for the patient.
Thanks to modern science there are multiple options for children born with congenital deficits that require prosthetics. These can range from passive devices to myoelectric systems.
After an amputation, sometimes the medical team recommends a support group for people who have lost a limb or directs the patient to individual therapy to help them with the trauma and encourage them to start the rehabilitation process as part of their recovery.
It is essential for the amputee's family to understand what their loved ones are dealing with, as well as supporting them during rehabilitation. This includes emotionally as well as in their day-to-day challenges.
Returning to work is another challenge for amputees, not only because returning to previous roles can be difficult but also sometimes the role of their vocation may have to change due to the level of amputation.
Rehabilitation is one of the most important aspects of life post-amputation. The purpose of rehabilitation is to get the individual healed (physically and emotionally), along with getting them use to life with a prosthesis. Rehab medicine has many facets and can include occupational therapy, physical therapy, vocational therapy, recreational therapy and of course prosthetic care.
Often the first therapy exercises are executed in the hospital. Patients are doing desensitizing and contracture prevention exercises, along with edema control and limb shaping.
Rehabilitation doesn’t stop at the hospital. It is crucial to continue your therapy after coming back home. Everyday exercises will help for quicker return to independence in everyday duties.
All these tasks prepare the limb and get it ready for the prosthetic fitting process.
For the patient, the loss of a limb means a change in everyday life habits. Physicians performing amputations keep in mind the limb length and shape that is needed for a successful prosthetic fit.
Thanks to modern technology such as the Zeus bionic hand patients can live a functional life with a bionic hand that can be customizable to their needs. Zeus can be controlled by the use of electrodes that read EMG signals, similar to how muscles operate. The hand comes with 12 grip patterns and each one is customizable down to the degree of each finger/thumb.
Using the modern materials, the Zeus is resistant to damage but also easy to repair when the need arises. This eliminates the need for the patient to be without their hand while it is being sent in for services. All servicing can be done in the prosthetist’s office.
Compared to other bionic hands available on the market, Zeus gives the user the most amount of control in their life.