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Post-traumatic lower-limb amputation: Indications, techniques and results.

Sylvain Rigal1, Alexia Milair2, Laurent Mathieu1

  • 1Hôpital National d'Instruction des Armées Percy, Service d'Orthopédie, Traumatologie et Chirurgie Réparatrice des Membres, 101 Avenue Henri Barbusse, 92140 Clamart, France; Académie de Santé des Armées, École du Val-de-Grâce, Chaire de Chirurgie Appliquée aux Armées, 1 Place Alphonse Laveran, 75005 Paris, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|September 1, 2025
PubMed
Summary

Traumatic lower-limb amputation decisions involve complex factors, including necessity, surgical techniques, and post-operative care. Expert surgical judgment is crucial for optimizing outcomes and patient quality of life.

Keywords:
Amputation Lower limbProsthetics disabilityTraumatology

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Area of Science:

  • Traumatology
  • Surgical Oncology
  • Rehabilitation Medicine

Background:

  • Traumatic lower-limb amputation presents unique challenges in emergency settings.
  • Decision-making for amputation versus limb salvage is complex and often debated.
  • Optimizing stump management and addressing post-operative complications are critical.

Purpose of the Study:

  • To review the indications for traumatic lower-limb amputation.
  • To evaluate the role of scoring systems in amputation decision-making.
  • To outline technical principles, quality of life expectations, complication management, and holistic care considerations for traumatic amputations.

Main Methods:

  • Comprehensive literature review addressing key questions on traumatic amputation.
  • Analysis of decision-making criteria, surgical techniques, and patient outcomes.
  • Synthesis of information on complication prevention, treatment, and long-term management.

Main Results:

  • Amputation indications include trauma severity, life-threatening conditions, poor functional prognosis, and mass-casualty events.
  • Score systems offer guidance but surgeon expertise remains paramount in emergency amputation decisions.
  • Technical principles emphasize non-closure in the acute phase and delayed stump shaping to minimize complications.
  • Prosthetics significantly improve quality of life, restoring autonomy.
  • Common complications include infection, cover defects, heterotopic ossification, and chronic pain, requiring specialized management.
  • Holistic care integrates regulatory, ethical, multidisciplinary, and psychosocial factors.

Conclusions:

  • Traumatic lower-limb amputation requires a multidisciplinary approach, balancing surgical necessity with functional outcomes.
  • Effective management hinges on appropriate surgical techniques, proactive complication control, and comprehensive patient support.
  • Optimizing quality of life post-amputation is achievable through advanced prosthetics and integrated care pathways.