Amputation

Question 1

What is the most common cause of lower limb amputations in the UK NHS?

Answer 1

Complications of peripheral arterial disease (PAD) and diabetes.

Question 2

How are amputations classified?

Answer 2

As major or minor amputations.

Question 3

What is the average age for major lower limb amputation in the UK?

Answer 3

Around 70 years.

Question 4

What is the gender distribution of major amputations in the UK?

Answer 4

Approximately 60% male and 40% female.

Question 5

What are other causes of amputations besides PAD and diabetes?

Answer 5

• Trauma
• military injuries
• neoplasm
• venous ulcers
• congenital deformities
• chronic pain
• neurological injury causing a non-functional limb.

Question 6

What is one of the most common causes of amputation worldwide in young men?

Answer 6

Trauma and military injurie

Question 7

What is a common type of minor amputation in the foot?

Answer 7

Transmetatarsal amputation.

Question 8

What other areas can minor amputations involve?

Answer 8

Midfoot, hindfoot, and ankle.

Question 9

What are the two main types of major lower limb amputation?

Answer 9

Below-knee amputation (BKA) and above-knee amputation (AKA).

Question 10

Which amputation generally allows better prosthetic mobility: BKA or AKA?

Answer 10

Below-knee amputation.

Question 11

What is the main goal when choosing the level of amputation?

Answer 11

To preserve as much limb length as possible while ensuring healing and functional recovery.

Question 12

Why is BKA preferred over AKA when possible?

Answer 12

Because walking with a below-knee prosthesis requires significantly less energy than an above-knee prosthesis.

Question 13

What medical conditions should be optimised before amputation surgery?

Answer 13

• Diabetes
• cardiovascular disease
• respiratory conditions.

Question 14

What psychological factors should be considered before amputation?

Answer 14

Emotional impact and mental health of the patient.

Question 15

What social considerations should be assessed pre-operatively?

Answer 15

Home environment and possible need for home adaptations.

Question 16

What complications should be monitored after amputation?

Answer 16

• Infection
• ischaemia
• stump trauma
• pressure injuries.

Question 17

What role does physiotherapy play after amputation?

Answer 17

• Rehabilitation
• strengthening
• helping the patient learn to walk with a prosthesis.

Question 18

What is stump modelling?

Answer 18

Shaping the residual limb to allow proper prosthesis fitting.

Question 19

What has contributed to improvements in prosthetic technology?

Answer 19

Research and development following military injuries.

Question 20

What is phantom limb sensation?

Answer 20

The feeling that the amputated limb is still present.

Question 21

What is phantom limb pain?

Answer 21

Pain perceived in the amputated limb.

Question 22

What does a major amputation usually indicate in PAD patients?

Answer 22

End-stage peripheral arterial disease.

Question 23

What is the in-hospital mortality rate for below-knee amputation in the UK?

Answer 23

About 6.7%.

Question 24

What is the in-hospital mortality rate for above-knee amputation in the UK?

Answer 24

About 12.4%.

Question 25

What is the 5-year survival rate after major amputation due to PAD?

Answer 25

Around 31%.

Question 26

How does this survival rate compare to bowel cancer?

Answer 26

Bowel cancer has a higher 5-year survival rate (~59%).

Question 27

What musculoskeletal problems can develop after amputation?

Answer 27

Joint issues such as hip arthritis due to altered gait with prosthetics.

Question 28

What lifestyle risk affects many elderly amputees?

Answer 28

Sedentary lifestyle and reduced mobility.

Question 29

What conditions cause most amputations in the UK?

Answer 29

Peripheral arterial disease and diabetes.

Question 30

Why is a multidisciplinary team (MDT) important in amputation care?

Answer 30

To manage surgical, medical, psychological, rehabilitation, and social aspects of care.

Question 31

What does amputation due to PAD or diabetes usually indicate?

Answer 31

Advanced disease with poor prognosis.