Amputations and advances in prosthetic limbs
Spencer Knaggs gives an overview of amputations and describes the recent medical advances in prosthetic limbs.
Amputations are not something that people want to think about, but they are a part of everyday life, especially for those innocently involved in accidents at work or road traffic accidents. However, with modern advances in surgery, rehabilitation and importantly prosthetic design the loss of a limb does not have to be a detrimental life sentence.
Amputations have been carried out since Hippocrates’ time when it was one of the main functions of a surgeon. Often as the result of war injuries amputations were very high risk procedures as there was no real way to control blood loss until the invention of the tourniquet at the Battle of Flanders in 1674, which led to significant improvements in fatality rates. By the time of the US Civil War there was an estimated 75% survival rate (from over 60,000 amputations).
Primitive examples of prosthetic replacement limbs have been discovered in Egyptian tombs and in New Mexico but advances in medicine and science have come a long way since then. Initially replacement limbs were introduced to provide the affected person with a small degree of function, but they were simple replacements often made of wood (for legs) or metal (for arms). Companies now compete to provide the best possible prosthesis and are at the cutting edge of science to ensure they are as close to a real limb as possible.
Nowadays they are often known as bionic limbs, being more aesthetically pleasing, as well as taking on a more realistic and functional form. Artificial limbs are lighter and have a greater range of movement than ever before providing a much greater degree of freedom for the user.
It is reported that only 5% of all amputations today are caused by road traffic accidents. Although statistically around 60% of amputations are performed on men with the average age for a lower limb amputation in the UK being 70 years, in the under fifties the leading cause of amputation is as a result of trauma.
For anyone who has lost a limb coping with the effects both physically and psychology can be very difficult, particularly when it comes to learning to adapt to the change in routine as well as the acceptance of the prosthesis and the residual limb.
From a legal perspective, an early admission of liability is helpful, together with early access to good rehabilitation, generally through an Immediate Needs Assessment. Good case management support throughout the rehabilitation process and access to suitable experts, suppliers and general resources makes a Claimant’s journey more manageable, providing them and their family with invaluable help and support through a very difficult time.
Physical and mental therapy is necessary to help the injured person adjust to the loss, allowing them to adapt and cope with everyday life. Appropriate help reduces the risk of long-term complications and allows for proper healing and management.
When it comes to the provision of prosthetics these can be prepared in a matter of weeks. A dedicated team of experts assess an individual’s needs, taking into consideration the life the individual lead before the amputation, their general health, ability to manage a prosthetic limb and what their aspirations are for the future.
Casts are taken (or in some cases scans) and a temporary socket is created, to assess how the individual’s limb works and to identify any areas of pressure. Once fitted together with the rest of the artificial limb further adjustments are made, often over the course of several months, before the final version is cast and created. In many cases additional residual limbs are required, particularly if someone participates in sport, where the traditional day-to-day limb is simply unsuitable.
The overall aim in all cases is to ensure the injured person can continue with their everyday routine, circumventing the need for substantial lifestyle changes. When it comes to a claim it is necessary to factor in the need for replacement prosthetics during a person’s lifetime, to include consideration of the person’s age, weight changes, health changes and to ensure the injured person is well educated in the care and use of the replacement limb.
It is reassuring that amputations today have little effect on life expectancy, albeit that there can be ongoing health issues such as phantom pain, wound infections and the risk of deep vein thrombosis. In spite of which by following a strict regime to care for the residual limb an active lifestyle can still be enjoyed.
With the recent success of Team GB athletes at the Paralympics proving that having an artificial limb does not have to restrict a person’s lifestyle or ambition, additional support from such organisations as The Limbless Association and The Douglas Bader Foundation means the future is brighter than it has ever been for amputees.