Amputation: Causes, Statistics, and Your Most-Asked Questions

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Doctors typically divide amputation types first into upper amputations and lower amputations. Upper amputations involve the fingers, wrist, or arm. Lower amputations involve the toes, ankle, or leg.

Ideally, if you need an amputation, a doctor will speak with you about the need for a certain location and prosthetic options.

The following are medical terms for certain amputation types.

Upper extremity

• Transcarpal. An amputation of a finger or a portion of the hand.
• Wrist disarticulation. An amputation through the wrist.
• Transradial. An amputation below the elbow.
• Elbow disarticulation. Amputation through the elbow or at elbow level.
• Transhumeral. Amputation above the elbow.
• Shoulder disarticulation. Amputation at the shoulder.

Lower extremity

• Toe amputation. Removal of one or more toes.
• Midfoot amputation. Removal of the toes and half of the foot, with the heel and ankle joint remaining. Also called a transmetatarsal amputation (TMA).
• Transtibial amputation. Also known as a below-knee amputation.
• Knee disarticulation. Also known as a through-knee amputation.
• Transfemoral amputation. An amputation above the knee.
• Hip disarticulation. An amputation in the area of the hip joint.
• Hemipelvectomy. An amputation of the entire leg and portion of the pelvis to the sacrum.

According to 2020 research, the largest percentage of amputations are related to chronic disease that impairs blood flow and affects bone tissue. However, there are additional amputation causes.

Amputations related to blood flow conditions

Chronic disease and infection can lead to interrupted blood flow that jeopardizes a limb. When this is the case, a doctor may recommend amputation to preserve as much of the limb as possible.

Chronic conditions are a leading cause of lower extremity amputations. The American Academy of Physical Medicine and Rehabilitation (AAPMR) estimates that 93.4 percent of all lower extremity amputations are related to vascular disease. This includes conditions such as diabetes and peripheral artery disease.

The most common lower extremity amputations related to blood flow conditions are:

• toe (33.2 percent)
• transtibial (28.2 percent)
• transfemoral (26.1 percent)
• foot amputations (10.6 percent)

Amputations due to chronic disease are associated with 5-year mortality rates that are higher than some cancer types. This is because the need for amputation in many instances can indicate a person’s medical condition or overall health is worsening. Enhancing a person’s healthcare and overall health are excellent goals after amputation.

Cancer-related amputations

Cancer-related amputation accounts for 0.8 percent of total amputations. This is often due to bone cancer or cancer that has metastasized to the bone. However, cancer is the most common amputation cause for those between the ages of 10 and 20.

Traumatic amputations

Injuries and trauma can lead to amputations. An estimated 5.8 percent of lower limb amputations are related to trauma. This can include injuries from car accidents and workplace-related accidents.

The Bureau of Labor Statistics estimates that 6,200 work-related amputations happened in the United States in 2018. More than 58 percent of these involved using some type of machinery, particularly metal and woodworking machinery.

Although you’ve already read some statistics related to amputation, here are a few more to consider from the Amputee Coalition, a nonprofit organization for amputees. They illustrate that if you or a loved one requires an amputation, you are not alone.

In the United States:

• An estimated 2.1 million people are living with limb loss.
• More than 507 people lose a limb each day.
• An estimated 3.6 million people are projected to be living with limb loss by 2050.
• The most common age range for amputations is 45 to 64 (46 percent of Americans). The second most common range is 65 to 84 (36 percent of Americans).
• Men experience limb loss in significantly higher numbers than women — 69 percent of amputees are men, while 31 percent are women.
• Upper limb amputations are less common than lower limb ones (35 percent upper limbs versus 65 percent lower limbs).

Those with diabetes are 8 to 24 times more likely to undergo a lower limb amputation than those who do not have diabetes, according to the AAPMR.

There are also significant racial disparities related to amputations. The Amputee Coalition says African Americans are four times as likely as white Americans to have an amputation. Experts are not sure why African Americans might have a higher risk, but this is likely due to social conditions rather than biological factors.

Because amputation removes a portion of the body that was naturally present, it’s easy to wonder how this affects your overall health. There are undeniably effects that can occur due to amputation. It’s important to work with your doctor and physical therapist to minimize these effects whenever possible.

Examples include:

• changes in your center of gravity and balance
• increased risk of arthritis in your remaining limb (if applicable) because it often has to increase its workload
• back pain due to changes in the body’s positioning for lower limb amputees

Often, the effects of an amputation are related to where it is and your overall health.

Amputation complications

Amputations are surgical procedures that have risks involved. Also, if the amputation was the result of trauma or infection, you may have other medical conditions to recover from as well. This can complicate recovery after amputation.

According to the AAPMR, some of the most common amputation complications include:

• infection
• pinched nerve
• phantom limb sensation and pain (feeling as if the limb is still there, even if it isn’t)
• residual limb pain

Another complication is joint contracture. This is when the remaining muscles, tendons, and other tissues tighten so much that you can’t move the remaining joint.

Amputation healing times can vary by the event that caused the amputation and the amputation site.

For example, amputations due to chronic conditions such as diabetes or peripheral artery disease may take longer to heal. Blood flow and wound healing are already impaired by these conditions, which may extend recovery times.

A small 2018 study suggests it likely takes less time to recover from a toe amputation than a leg amputation. A surgeon should help you determine your expected recovery period.

Some tips to help the recovery process:

• Follow wound care instructions carefully. Most surgical incision sites should be kept clean and dry. Notify your doctor if you experience significant drainage or infection signs.
• Take medications such as antibiotics as prescribed. This can help prevent surgical site infections.
• Participate in physical therapy as you are able to keep muscles strong and tendons and other tissues mobile.

It can take time to regain function after an amputation. Some individuals undergoing leg amputations reported it took as many as 6 months to regain their functional independence.

If you are wondering where amputated limbs go, you aren’t alone. Especially if you’re about to undergo an amputation, it’s fairly common to ask questions about how and where these limbs are disposed of.

A 2019 study described four potential destinations for your limb after the procedure. The limb could be:

• sent to a biohazard crematoria where it is destroyed
• donated to a medical college for use in dissection
• sent to a pathologist for testing, such as for cancer cells or infection
• returned to you if you have a proven religious need to retain the limb

If you are unsure where your limb is going, you can ask your surgeon.

Amputations can occur for many reasons, but most are related to chronic medical conditions that affect blood flow. If you do require an amputation, your surgeon should explain the type and recovery expectations to you before the procedure.

There are many support groups available for those who’ve had an amputation. Many of them offer free online or in-person resources.