Physical therapists often evaluate and treat people who have had an amputation of the leg or legs. There are many different types of lower extremity amputations including hip, knee, ankle and foot amputations, and your rehabilitation may differ significantly depending on the type of amputation that you have had.
Different types of walking aids and prostheses are used for different types of amputations, so your physical therapist should have an understanding of the type of amputation that you have had. This way, you can maximize your ability to regain normal walking function.
If you have had an amputation, be sure you are familiar with the type of amputation that was performed. This may help you know what to expect from physical therapy and rehabilitation.
Remember that a lower extremity amputation is a complicated surgery, and the rehabilitation process involves many different individuals. These people include your physical therapist, occupational therapist, social worker, psychologist, and doctor. They must all work together to help you maximize your functional mobility and have a positive outcome after a lower extremity amputation.
1. Above Knee Amputation
An above knee amputation (AKA) is one where the leg is amputated through the thigh bone above the knee joint. This type of amputation is also referred to as a transfemoral amputation. Most often the amputation occurs at the middle part of the thigh bone. The residual limb is comprised of your femur, and no knee joint is present. An AKA may lead to significant loss of muscular control in the hamstrings and quadriceps muscles, making walking with a prosthesis difficult.
2. Below Knee Amputation
A below knee amputation (BKA), also known as a transtibial amputation, is an amputation through your shin bone. The BKA is the most common type of amputation performed, and the risk of serious post-operative complications in a BKA is far less than in a transfemoral amputation. In a BKA, the knee joint is spared, and walking with a prosthesis is typically more successful.
3. Hemipelvic Amputation
A hemipelvic amputation is one where your hip joint and part of your pelvis is amputated. This type of amputation is also known as a transpelvic amputation. It is most often performed because of a malignant tumor or as the result of trauma. Walking after a hemipelvic amputation is difficult since there is no residual limb onto which a prosthesis can be fitted. Still, your physical therapist and doctor can work with you to fit you with the most appropriate device to help maximize your ability to walk.
4. Toe Amputation
Toe amputations usually occur as the result of poor blood supply to the toe, a situation that sometimes develops in gangrene. This type of amputation rarely requires the skilled rehabilitation of physical therapy, but occasionally therapy will be involved in the rehabilitation process if balance or gait issues are limiting functional mobility.
5. Partial Foot Amputation
A partial foot amputation is one where the toes and part of the long bones of the foot are amputated. This is also known as a transmetatarsal amputation. A partial foot amputation allows you to still maintain a high level of functional mobility because many major muscle attachments are preserved during the surgery. Also, foot balance and shape are maintained in this type of amputation, which can help you keep your proper gait.
Disarticulation refers to an amputation through a joint. For example, if your shin bone is amputated, then the part of your knee joint at the end of your thigh bone would be spared. This can make walking easier. Since the bone of the residual limb is left intact, there is a decreased chance of bone infection from the amputation surgery. A disarticulation amputation in a child also helps to preserve the growth plate in the bone.