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Amputations

An amputation describes a complete detachment of a body part. A partial amputation occurs when a body part is incompletely detached, but there is also loss of blood supply. Because of the associated loss of blood supply, a partial amputation is not expected to survive unless blood flow is reestablished (revascularization). Depending upon the level and type of injury, replantation or revascularization may or may not be possible. Treatment options for partial and complete amputations include leaving the open amputation stump to heal by primary wound contracture, shortening of the amputation stump followed by direct closure, coverage of the amputation stump by grafts or flaps, or microsurgical replantation.

The primary consideration in treating amputations involving the hand and upper extremity is the potential for functional rehabilitation. Certain traumatic amputations can and should be reattached, specifically when expectations for function would be better than if it had not been reattached. However, replantation is often contraindicated secondary to the nature of the injury and soft tissue involvement. Following amputation, usually intensive specialized therapy is beneficial to maximize function and minimize complications. Select individuals who have sustained amputations, which were not replanted, may benefit from digital or upper extremity prosthetics. These prosthetics may improve both function and the aesthetic appearance of the amputated site.

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