Foot amputation: rehabilitation, possible consequences

There are situations when it is simply impossible to cope with a problem without surgical intervention. In this article I want to talk about rehabilitation measures after amputation of the patient's leg.


Basic terms

At the very beginning, you need to understand the terms that will be actively used in the article.

  1. So, amputation of the leg is the removal of the patientlimbs surgically. The purpose of this action is the saving of human life. It is worth saying that the decision to surgical intervention of the doctor is taken only in the most extreme case.
  2. The level of amputation is the place where the leg is cut off.
  3. Rehabilitation is a set of measures, with the help ofwhich specialists of various profiles (physicians, psychologists, orthopedists, prosthetists) teach a person to adapt to everything around him without a lost limb.


Indications for amputation of the lower extremity maybe set. One of the reasons is diabetes mellitus. The disease itself can not lead to this problem. However, in some cases (neglect of the disease, its transition into a decompensated form), medical indications for amputation are possible (this occurs in about 8-10% of patients). In what cases can an amputation of the foot be prescribed in diabetes?

  1. Neuropathy, associated specifically with nerve damage.
  2. Micro- and macroangiopathy (this is a violation of the structure and normal functioning of both large and small vessels).
  3. Necrotic changes occurring in the lower limbs.

As it became clear, the first and most importantindications for amputation is a disruption of the functioning of the vessels of the leg. This is due to disruptions in the metabolism and the development of a process such as autoimunization. In the vessels stagnation occurs, oxygen starvation occurs, which makes the legs vulnerable to various infections. And even the slightest bruise can provoke the development of the most terrible purulent processes. To avoid a fatal outcome, in such situations, doctors make a radical decision. That is, the patient needs an amputation of the leg (in diabetics such cases are not unique). Often only this way you can save a patient's life.

amputation of a foot in diabetes

What is important

As it became clear, amputation of the leg is seriousinterference in the life and health of the patient. That is why after the operation a person expects a rather long period of rehabilitation. It is worth saying that the success of restorative treatment depends on several factors:

  1. Good stump (value is the quality of the operation itself).
  2. Appropriate prosthesis (important is the qualitative work of the prosthetist).
  3. Rehabilitation program.

If at least one of these items is performed is not perfect, the rehabilitation process can be significantly delayed.

Postoperative period

Regardless of whether an amputation of the toe or most of the limb has been performed, the early postoperative stage of restorative treatment remains critical. What is important in this case:

  1. It is necessary to prevent various types of complications, for example infection of the stump.
  2. It is very important to monitor blood and lymph circulation in the limb.
  3. It is necessary to prevent stiffness in joints and muscle hypotrophy. In this case, you need massage and therapeutic gymnastics.
  4. It is also necessary to regulate painful sensations, as much as possible avoiding them.
  5. And, of course, you need psycho-emotional support for the patient. After all, for almost all people, the loss of a limb is a tremendous blow.


Stage of rehabilitation 1. Stump preparation

If the patient underwent surgery "amputationlegs ", during the first year after surgery, several levels of rehabilitation will be needed. So, as has already been said above, the quality of the stump is of the greatest importance. It depends on many factors:

  1. The length of the stump.
  2. Level of amputation.
  3. Postoperative scar (it should be located away from the places of maximum axial load).
  4. Forms of stump (it depends on the technique by which the surgical procedure was performed).
  5. Contractures, that is, restrictions on the volume of motion. This is of great importance, since it is on this factor that the quality of the person's further walking depends.

What else is important to know about the care of the stump

After the leg was amputated,it is very important to properly care for the postoperative suture. In the early days, he will be supervised by a doctor and a nurse. Here you need to clarify that special attention deserves patients with vascular pathology and diabetes, as these diseases increase the risk of infection stump. What is important:

  1. Very important hygiene stump. A daily contrast shower is desirable. You can wash your foot with baby soap, after wiping it dry with a towel.
  2. The cult should be examined daily for changes in skin color. This is very important, and with the slightest changes you need to seek advice from a doctor.
  3. After the operation, the stump skin becomes verysensitive. You can cope with this with a massage. You can do it with both hands and a small rubber ball, making circular motions. Periodically, the stump should be rubbed with a towel. Do these procedures as often as possible, preferably several times a day.
  4. It should be remembered that the postoperative scar needs to be moistened. This is especially important in the first few weeks after the leg was amputated.

The period of postoperative adaptation in patients with diabetes is usually longer.

amputation leg rehabilitation


The field of how the leg was amputated underdiabetes mellitus, or any other disease, the patient often develop swelling. It's not scary, because this is a normal reaction of the human body to surgery. However, the situation still should not be allowed to run its course. Measures to be taken:

  1. In the first time after the operation on the wound, pressure can not be exerted. Therefore, the bandage is superimposed on the stump.
  2. In order to cope with swelling, you can use the following tools: compression knitwear, elastic bandage, silicone cover.
  3. If a high leg amputation was performed,the patient is recommended twice a day to lie down on his stomach (for half an hour), turning his head in a convenient direction. This is necessary for the muscles on the cult to stretch and thus train and relax.

Contracture of the joint

Another problem that may arise afterAmputation of the foot is the contracture of the joints. That is, the limitation of passive movement in the joint, which can be caused by deformation of muscles, tendons, skin, etc. Preventive measures:

  1. The most important thing is to provide the patient with the correct position of the limb. The cult should be straightened, for a long time in a bent position it can not be left.
  2. It is important to timely eliminatepuffiness and pain. To prevent deformation of the spine, it is necessary to use an armchair with a special stump for the stump in the first postoperative period.
  3. The patient will also need both passive and active therapeutic gymnastics. However, you need to remember that you should avoid those exercises that cause pain.

Important point: As soon as possible after surgery, the patient should appear to the prosthetist. After the earlier a person stands on the prosthesis, the less he will lose the most important dynamic skills, and the easier and sooner the rehabilitation process will be completed.

after amputation of the leg

Phantom pain

Regardless of whether the leg was amputatedabove the knee or below, the patient may be suffering from phantom pain. This is the pain that the patient feels in the limb, cut off by surgery. To avoid this, the following points are important:

  1. The patient should be activated as soon as possible, that is, transferred to a sitting position.
  2. Massage and lymphatic drainage of the stump are needed.
  3. The pressure in the cult should be uniform. Therefore, it is very important that the limb is properly bandaged.
  4. You can avoid phantom pains if a person starts exercising as early as possible. Physiotherapy is also important.
  5. And, of course, the most important is the earliest possible prosthetics.

If phantom pains appeared in the late period(not immediately after the operation), this means that care for the stump was carried out incorrectly or insufficiently. However, in such cases it is possible to cope with the problem. Mirror therapy can help.

Stage of rehabilitation 2. Prosthetics

After the leg was amputated,rehabilitation begins with the preparation of the stump for prosthetics and the prosthesis itself. What does this concept mean? Thus, prosthetics is a specialized type of care for patients who have lost part of the desired organ. That is, with the help of a prosthesis it is possible to restore the normal or close to normal functionality of the lost organ.

About the prosthesis itself

Modern doctors say that afterAmputation of the foot is important as early as possible prosthetic limb. So, primary prosthetics should be carried out already on the 14-21th day after surgery. Repeated prosthesis is prescribed already as and when the wear of the primary product occurs.

Stages of prosthetics

The process of prosthetics consists of a number of stages:

  1. The choice of the design of the product, i.e., the prosthesis.
  2. Removing the measurement from the stump.
  3. Preparation of gypsum positive and negative.
  4. Assembling the product to fit.
  5. The final finish taking into account all the moments and wishes.
  6. Prosthesis delivery.
  7. Learning to use.

Speaking generally, the success of a professionalrehabilitation of the patient depends almost entirely on the quality of the manufactured prosthesis. Its weight, dimensions, control method, design, aesthetics and cosmeticity are important. Also, you need to properly adjust the product for a single patient. And, of course, the final stage of rehabilitation is the very mood of the patient and his desire to return to normal life as soon as possible. If a person had an amputation of the toe, the prosthesis would not be needed. This point of rehabilitation can be avoided.

amputation of a foot in diabetes mellitus

About dentures

It should be said that the prosthesis itself is of two types: primary and secondary.

  1. Primary prostheses are also calledtraining and training. They are necessary in order to properly form the stump, as well as to teach the patient the primary skills of their use. It should be said that as early as possible, initial prosthetics makes it possible to prevent the occurrence of restrictions of movements in large joints. It is also important to clarify that this prosthesis is carried out in a hospital, because it requires the participation of many specialists.
  2. After the stage of primary prosthetics, the patient is given a permanent prosthesis (an average of two years).

Types of prostheses

Prostheses are made by the most different technologies. They are modular and non-modular (however, modular prostheses are most often used). They consist of the following parts:

  1. Receiving sleeve, which is made depending on the impression of the stump of the patient.
  2. Adjusting-connecting devices.
  3. The carrier module. Varies depending on the required length of the prosthesis.
  4. The module of the foot.
  5. Fixation of the prosthesis.

Also worth mentioning is that a permanent prosthesis,in contrast to the training, also supplied with cosmetic lining, on top of which a special stocking is put on. This is necessary for the prosthesis to resemble the real leg as much as possible.

amputation of a leg above the knee

About disability

It is worth saying that the person isdisability with leg amputation. So, most likely, at first it will need to be confirmed once a year. However, after a certain time (no later than four years) you can apply for a so-called permanent disability. If there is an active development of the prosthesis, according to the decision of the commission, it is possible to reduce the disability group.

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