Foot amputation

High urgency
-Moderately severe

Separation of the foot from the rest of the leg.

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, bleeding 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 traffic or workplace accidents and war injuries.

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 the death of the patient if they are not controlled.

In cases of traumatic amputation, a tourniquet may be used to stop bleeding until surgical revision is performed. If the amputated limb and residual limb are properly cared for, reattachment of the amputated limb in a specialised centre may be considered.

Bibliographic references
  1. Pinzur MS, Pinto MA, Schon LC, Smith DG. Controversies in amputation surgery. Instr Course Lect 2003; 52:445.
  2. Pinzur M, Kaminsky M, Sage R, et al. Amputations at the middle level of the foot. A retrospective and prospective review. J Bone Joint Surg Am 1986; 68:1061.
  3. Venkat Kalapatapu, MD. Techniques for lower extremity amputation. UpToDate. 
  4. Heikkinen M, Saarinen J, Suominen VP, et al. Lower limb amputations: differences between the genders and long-term survival. Prosthet Orthot Int 2007; 31:277.
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Symptoms

    Foot traumatic amputation


    Right foot traumatic amputation


    Left foot traumatic amputation


    Wound/cut on the foot


    Pain in the lower third of the leg

Pre-hospital care recommendations

Press to stop the bleeding.
Apply a clean bandage that does not stick to the wound.
In case the blood leaks through the placed bandage, place a new bandage on top of the previous one.
Wrap the amputated body part in clean, dry gauze.
Place the body part in a waterproof plastic bag. Immerse the bag in ice and water, but do not let the amputated part get wet or freeze.
If it is not possible to stop the bleeding with compressive bandages, a tourniquet should be applied.