Lower Extremity Amputation: Multidisciplinary Prosthetics and Orthotics, Physical Therapy Rehabilitation, Radiologic Evaluation, and Laboratory-Based Perioperative Optimization
Abstract
Background: Lower extremity amputation is a major surgical intervention often necessitated by advanced vascular disease, diabetes-related complications, infection, or trauma. It represents not only a limb-removal procedure but a multidisciplinary continuum of care involving surgical, medical, rehabilitative, and psychosocial domains.
Aim: To review the indications, contraindications, anatomical considerations, operative techniques, perioperative optimization, and multidisciplinary strategies that influence outcomes in lower extremity amputation.
Methods: This comprehensive review synthesizes current evidence and clinical principles regarding amputation planning, level selection, surgical technique, anesthesia choice, and postoperative rehabilitation. It integrates anatomical and physiologic insights with epidemiologic data and outcome predictors, drawing on published literature and clinical guidelines.
Results: Amputation rates remain high, particularly among diabetic and dysvascular populations, with annual U.S. healthcare costs exceeding $4.3 billion. Preservation of knee joint function significantly improves mobility and energy efficiency, while inadequate perfusion or infection mandates more proximal levels. Mortality remains substantial—up to 22% at 30 days and 68% at five years—reflecting systemic disease burden. Complications include wound failure, phantom limb pain, and psychological distress, necessitating integrated pain management and mental health support. Early prosthetic involvement and structured rehabilitation improve functional recovery and quality of life.
Conclusion: Lower extremity amputation is a life-saving yet life-altering procedure requiring meticulous surgical execution and coordinated interprofessional care. Optimal outcomes depend on individualized level selection, medical optimization, and proactive rehabilitation planning.
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References
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Copyright (c) 2025 Abdualaziz Mohammed Faqihi, Fadel Hassan Alkhamis, Adel Abdulrahman Al Ljher, Manal Ibrahim Alnamin, Abdulelah Shead Alharbi, Sultan Tulayhan Ayed Alharbi, Khulud Homoud J Alanazi, Raed M. Al-Otabibi , Mustafa Hassan Al Darwish, Ahmed Yahya Ahmed Ghazi, Mohammed Abdu Hamdhy
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