Management

Traumatic Amputation of the Extremity - Emergency Management

Editors: Margaret J. Lin-Martore MD; Luz Silverio MD; Rachel Chin MD

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Background Information

Description

  • Traumatic removal of a body part, usually an extremity()
  • Amputations are either partial (appendage still attached) or complete (appendage completely separated form body)

Anatomy

  • Amputation may damage numerous structures: skin, muscle, tendon, vasculature, nerves, bone

Etiology

  • Avulsion: ripped and jagged edges()
    • More associated morbidity
    • Least successful rates of replantation
    • Most frequent type of amputation
  • Guillotine: clean edges()
    • Higher rate of successful replantation
    • Least frequent type of amputation
  • Crush: irregular edges()
    • Damaged tissue is usually crushed making it harder to replant

Epidemiology

  • 5:1 predominance of males to females(,,)
  • More common in children and elderly(,,)
  • Upper extremity amputations more common than lower extremity amputations
    • Caught between 2 objects, doors, power tools, gunshot are frequent causes
  • Lower extremity amputations
    • Power tools and motor vehicle collisions are the most common causes
  • PEDIATRICS: accounts for 54% of the cases of traumatic amputations
    • Usually fingers and toes
    • Typically in young (aged 0-5 years) and older (aged 15-17 years) children()
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