Amputation Levels: Classification of Limb Removal Types

Amputations are classified based on the specific level at which a limb is removed. This classification typically follows anatomical regions and varies depending on whether it involves the upper or lower limb. This document provides a detailed breakdown by anatomical region:

Upper Limb Amputation Levels

Partial Hand Amputations (Transphalangeal)

• Finger Amputation: Removal of one or more fingers at the distal, middle, or proximal phalanx level.
• Thumb Amputation: Particularly significant due to its importance in grip function.
• Metacarpal Amputation: Loss of part or all of the hand while preserving the wrist.

Wrist Disarticulation

• Wrist Disarticulation: Amputation through the wrist joint, preserving the forearm bones.

Below Elbow Amputation (Transradial)

• Short Transradial: Amputation close to the elbow, reducing leverage.
• Long Transradial: Amputation closer to the wrist, allowing for better prosthetic control.

Elbow Disarticulation

• Elbow Disarticulation: Removal of the forearm at the elbow joint, preserving the humerus.

Above Elbow Amputation (Transhumeral)

• Short Transhumeral: Amputation closer to the shoulder, limiting leverage.
• Long Transhumeral: Amputation closer to the elbow, allowing for better prosthetic attachment.

Shoulder Disarticulation

• Shoulder Disarticulation: Amputation at the shoulder joint, removing the entire arm.

Forequarter Amputation (Interscapulothoracic)

• Forequarter Amputation: Removal of the entire arm, shoulder girdle, and part of the scapula and clavicle.

Lower Limb Amputation Levels

Partial Foot Amputations

• Toe Amputation: Removal of one or more toes.
• Ray Resection: Removal of a toe and its associated metatarsal bone.
• Transmetatarsal Amputation: Amputation through the metatarsal bones.
• Lisfranc Amputation: Amputation at the tarsometatarsal joint.
• Chopart Amputation: Amputation at the midtarsal joint (between talus/navicular and calcaneus/cuboid).

Ankle Disarticulation (Syme's Amputation)

• Syme's Amputation: Removal of the foot at the ankle joint while preserving the heel pad.

Below Knee Amputation (Transtibial)

• Short Transtibial: Amputation close to the knee, reducing leverage.
• Long Transtibial: Amputation closer to the ankle, allowing for better prosthetic control.

Knee Disarticulation

• Knee Disarticulation: Removal of the lower leg at the knee joint, preserving the femur.

Above Knee Amputation (Transfemoral)

• Short Transfemoral: Amputation near the hip, reducing prosthetic control.
• Long Transfemoral: Amputation closer to the knee, allowing for better leverage.

Hip Disarticulation

• Hip Disarticulation: Removal of the entire leg at the hip joint while preserving the pelvis.

Hemipelvectomy (Transpelvic Amputation)

• Hemipelvectomy: Removal of the entire leg along with part of the pelvis.

Hemicorporectomy (Translumbar Amputation)

• Hemicorporectomy: Removal of both lower limbs along with the pelvis and lower abdominal structures.

Clinical and Functional Considerations for Amputations

• Higher-level amputations (e.g., above elbow or above knee) typically result in greater functional loss and require more complex prosthetic solutions.
• Lower-level amputations (e.g., partial foot, transtibial, transradial) offer better mobility and function with proper rehabilitation.
• Disarticulations (e.g., knee or elbow disarticulation) preserve joint function, making prosthetic fitting easier compared to higher-level amputations.