Separation of the arm from the rest of the limb that remains attached to the torso.
The cause is usually traumatic although it may be secondary to elective surgery.
When amputation is performed in the context of surgery, blood vessels are ligated to prevent bleeding before cutting tissue and cartilage. The most frequent causes are diseases that cause poor blood circulation, tumours, deformities, infections and/or gangrene.
When the amputation occurs in the context of trauma, the haemorrhage and tissue loss are usually greater. If the limb has been torn off or avulsed, the bleeding can be massive and the surgical repair very difficult. The most frequent causes are bites, traffic accidents, work accidents and injuries secondary to aggressions.
The treatment of choice is surgical and its priority is to save as much tissue as possible and avoid bleeding and infection. Severe cases can lead to death of the patient if they are not controlled.
In cases of traumatic amputation, a tourniquet can be done to stop the bleeding until surgical revision is performed. If the amputated limb and the stump receive appropriate care, its reattachment in a specialised centre may be considered.
- Jeremy W Cannon, MD, FACS; Todd E Rasmussen, MD, FACS, COL, USAF, MC. Severe extremity injury in the adult patient. UpToDate.
- Finkelstein EA, Corso PS, Miller TR, et al. The incidence and economic burden of injuries in the United States, Oxford University Press, New York 2006.
- Belmont PJ Jr, Goodman GP, Zacchilli M, et al. Incidence and epidemiology of combat injuries sustained during "the surge" portion of operation Iraqi Freedom by a U.S. Army brigade combat team. J Trauma 2010; 68:204.
- Fox CJ, Gillespie DL, O'Donnell SD, et al. Contemporary management of wartime vascular trauma. J Vasc Surg 2005; 41:638.
- Meling T, Harboe K, Søreide K. Incidence of traumatic long-bone fractures requiring in-hospital management: a prospective age- and gender-specific analysis of 4890 fractures. Injury 2009; 40:1212.
- Schlickewei W, Kuner EH, Mullaji AB, Götze B. Upper and lower limb fractures with concomitant arterial injury. J Bone Joint Surg Br 1992; 74:181.
- White JM, Stannard A, Burkhardt GE, et al. The epidemiology of vascular injury in the wars in Iraq and Afghanistan. Ann Surg 2011; 253:1184.
- Swan KG Jr, Wright DS, Barbagiovanni SS, et al. Tourniquets revisited. J Trauma 2009; 66:672.
