The loss of a limb is one of the most devastating events in a person’s life. Recovering from this event is a process that every amputee goes through at a different pace and with different support systems.
People can lose all or part of an arm or leg for a number of reasons. Common ones include
- Problems with blood circulation. These may be the result of atherosclerosis or diabetes. Severe cases may result in amputation.
- Injuries, including from traffic accidents and military combat
- Cancer
- Birth defects
Post-surgery
Unless otherwise indicated, compression should be maintained around the residual limb. Reducing postoperative swelling will reduce pain and increase circulation so that healing can occur as quickly as possible.
Phantom sensation is a term used to mean any type of sensation which the amputee experiences in the portion of the limb that has been removed. It can include: tingling, warmth, cold, pain, cramping, constriction, and any other imaginable sensation. Essentially, any sensation that the limb could have experienced prior to the amputation, (and some which it could not), can be experienced in the amputated “phantom” limb.
Prosthetic Fitting
The type of prosthesis depends on the location and length of your residual stump and you’re functional and lifestyle needs. The prosthesis replaces some of the function and appearance of the missing body part. If your hand is amputated through or above the wrist, you may be given full-arm prosthesis with an electric or mechanical hand. Some patients may decide not to use a prosthesis.
The process of fitting prostheses differs from facility to facility. However, with each type of amputation there are a few common techniques:
- The residual limb will be measured either with a casting technique or by using one of several methods. A cast will be formed from these measurements and used as a mould for the socket.
- One or more clear plastic diagnostic sockets may be fit onto the patient to check for the best fit.
- The final socket and components will be aligned and fit onto the patient.
- The patient will be given preliminary training in the use of the prosthesis and instructions on donning and doffing (putting on and taking off) as well as instructions concerning stump/skin care.
- To maintain a good prosthetic fit and avoid skin breakdown, it will be necessary to check the fit and alignment of the new prosthesis frequently. As postoperative swelling goes down, the socket will have to be constantly adjusted – sometimes just adding a prosthetic sock will be enough – to accommodate the change in size. This is perfectly normal and will lessen as time goes by.
- Once the residual limb seems to have stabilized, the definitive socket and/or prosthesis will be fabricated. It is important to know, however, that although the changes have slowed down, minor changes will continue for several years. When in doubt about the fit, the patient should consult his or her prosthetist.
Featured above is an amputee with an above knee prosthesis.
Prosthetic Care
- Wash anything that makes skin contact (liners, socks, the inside of the socket, etc.) every day with mild soap and water and allow plenty of time to dry. Follow manufacturers’ instructions for care of liners. Unless specifically instructed, do not use anything containing alcohol or unknown chemicals.
- You should know the landmarks of when your socket fits correctly; if you don’t, ask your prosthetist to show you. If your socket is too big or too small, visit your prosthetist immediately.
- Make sure your shoe height is correct for your prosthesis or your alignment will be wrong, putting a strain on your residual limb and surrounding joints.
- Keep a “leg” bag handy with items you might need in an emergency (stump socks, pull socks or bandages, antibiotic ointment, antihistamine ointment, etc.).
- Remember – the fit of your prosthesis changes during the day, so add socks when needed.
- If you are having trouble with the prosthesis or liner, do not make your own adjustments or alter the prosthesis/ liner – call your prosthetist immediately
Limb amputees, as well as individuals living with limb differences or limb impairments like brachial plexus, drop foot, club foot, represent an important and large segment of the adaptive athlete community.
These individuals can participate in a wide-variety of Paralympic sports, including but not limited to Track and Field, Swimming, Triathlon, Sitting Volleyball, Cycling, Canoeing, Power Lifting, Table Tennis, Equestrian, Rowing, Wheelchair Fencing, and Wheelchair Basketball, Wheelchair Tennis. In addition to the Paralympic sports, there are many adaptive sports that are accessible and popular with amputees and those living with limb differences, including golf, rock climbing, surfing, skateboarding, wake boarding, kayaking, snowboarding, and stand-up paddling.
