The misleading terminology of minor amputation of the lower limb

A pronounced loss of function of the lower limb of various origins, especially with an infection-related course, may require a minor (MIN) or major (MAJ) amputation of the lower limb. Our aim was to contrast the underlying etiology, including previous trauma, surgical procedure, and the subsequent function.

Between 2012 and 2022, 366 lower limb amputations were considered. After excluding isolated toe amputations and knee disarticulations, 80 amputations of 77 patients (66 male; 11 female; mean age: 57.2 years) were included in this monocentric retrospective study and their clinical outcome was evaluated. Briefly, 23 patients underwent MIN and 54 patients, including three bilateral cases, underwent MAJ. Patient demographics, etiology, level of amputation, prosthesis fitting, mobility based on the K-Level categories, SF-12 questionnaire, PLUS-M 12-item short form, and problems in coping with everyday life were recorded. The mean follow-up period was 3.9 years.

The mean SF-12 score of all patients was 36.9 (MIN: 37.24; MAJ: 36.85) for the physical summary component and 50.0 (MIN: 52.32; MAJ: 48.46) for the mental summary component; the mean Plus-M 12 score was 49.5 (MIN: 50,08; MAJ: 48,46) (p > 0.05). K-level 3 was the most common in all patients (MIN: 47.8%, MAJ: 42.6%), defined as an unrestricted outdoor walker.

With MIN and MAJ results comparable in all scores and queries, it emphasizes the fact that even supposedly lower-limb MIN represents a considerable impairment of coping with daily life. If there is no prospect of preserving the limb, early transtibial amputation should be considered. However, our results support the good outcome despite lower-limb MAJ through modern prosthetic fitting.