Amputation: Definition, Classification, and Surgical Types

Understanding Amputation

Amputation refers to the surgical removal or traumatic loss of a part of the body, usually an extremity such as a limb or a digit (finger or toe). It can be either elective (planned surgery) or traumatic (accidental).

Amputations are performed for various medical reasons, including severe trauma, infections, tumors, vascular diseases, or congenital deformities when the limb or part is non-functional or threatens the patient’s health.

Classification of Amputation

Amputations are classified based on various criteria, such as level, cause, and technique:

1. Classification by Level

• Upper Limb Amputations:
  • Forequarter (scapulothoracic) amputation: Removal of the entire arm including the scapula and clavicle.
  • Shoulder disarticulation: Removal of the entire arm at the shoulder joint.
  • Above Elbow Amputation (Transhumeral): Through the humerus.
  • Elbow disarticulation: Removal at the elbow joint.
  • Below Elbow Amputation (Transradial): Through the radius and ulna.
  • Wrist disarticulation: Removal at the wrist joint.
  • Partial hand or finger amputation: Removal of parts of the hand or digits.
• Lower Limb Amputations:
  • Hemicorporectomy: Removal of the body below the waist (rare).
  • Hip disarticulation: Removal of the entire leg at the hip joint.
  • Above Knee Amputation (Transfemoral): Through the femur.
  • Knee disarticulation: Removal at the knee joint.
  • Below Knee Amputation (Transtibial): Through the tibia and fibula.
  • Ankle disarticulation (Syme's amputation): Removal at the ankle joint.
  • Partial foot or toe amputation: Removal of part of the foot or toes.

2. Classification by Cause

• Traumatic Amputation: Due to accidents, industrial injuries, war injuries, etc.
• Surgical/Elective Amputation: Planned removal due to:
  • Vascular diseases (e.g., diabetic gangrene)
  • Malignant tumors
  • Severe infections (e.g., osteomyelitis)
  • Congenital deformities

3. Classification by Technique

• Open Amputation: The wound is left open or closed partially to allow drainage, commonly used in infected cases.
• Closed Amputation: The wound is closed completely, usually by creating a flap of skin and muscle to cover the bone.
• Guillotine Amputation: Quick removal of the limb with a straight cut, usually temporary before definitive closure.

Summary Table