- Physical impairment
- Pain and phantom limb sensations
- Prosthetic fabrication and adjustments
- Amputation rehabilitation
Limb Loss and Amputation Rehabilitation
Losing a limb is a profound and life-altering experience. Here at our institute, we are committed to not just restoring physical function but nurturing the spirit that fuels your strength. Our approach goes beyond surgical precision, embracing the holistic well-being of each patient and recognizing the emotional and psychological aspects that accompany such profound change. With advances in surgery and modern prosthetic technology, we’ve helped hundreds of patients re-adjust to their everyday activities. Patients from around the world come to us for help with:
What We Treat
Limb loss is a physical and functional change that can contribute to a range of physical and psychological issues. As such, collaborative care involving healthcare professionals, rehabilitation specialists, and mental health providers is essential to address the diverse challenges associated with limb loss and to promote the best possible outcomes for individuals adjusting to life with an amputation. Our team of experts specializes in treating all aspects of limb loss, including:
Neuromas
When a limb is amputated, the cut nerves attempt to regenerate and may form a tangled mass of nerve tissue known as a neuroma. This cluster of nerves can be sensitive and may send pain signals, leading to discomfort and phantom limb pain in the individual's residual limb.
Phantom Limb Pain
As many as 80 percent of individuals who have undergone limb loss experience some degree of phantom limb pain. Phantom limb pain is the perception of pain or discomfort in a limb that is no longer present and is often the result of nerve damage or entrapment.
Phantom Sensation
Phantom sensation is the perception of non-painful sensations that feel like the missing limb is still a part of the body, such as touch, movement, or warmth.
Residual Limb or Stump Pain
Residual limb or stump pain is pain or discomfort experienced in the remaining portion of a limb following amputation. This condition is often attributed to nerve irritation, neuromas, or changes in soft tissue.
Skin and Soft Tissue Issues
Changes in weight distribution and pressure points due to limb loss may lead to skin irritation, pressure sores, or soft tissue problems, especially for individuals using prosthetic devices.
Joint Issues
Changes in movement patterns resulting from limb loss can impact joints in the remaining limb as well as other areas of the body. Over time, this can contribute to chronic joint pain, arthritis, and musculoskeletal issues.
Prosthetic-Related Complications
While prosthetic devices aim to enhance mobility, issues such as skin irritation, discomfort, or problems with fit may arise. Regular maintenance and proper prosthetic care are essential to prevent complications.
Treatments for Limb Loss
Advanced surgical treatments for limb loss have witnessed remarkable progress, providing individuals with innovative solutions to enhance function and improve quality of life. Cutting-edge techniques and microsurgical procedures, including nerve grafting and targeted muscle reinnervation, contribute to improved functional outcomes by restoring nerve connectivity and optimizing muscle control. These advancements exemplify the forefront of medical innovation, empowering individuals who have experienced limb loss with unprecedented possibilities for mobility, independence, and a renewed sense of normalcy.
Non-Surgical Treatments for Limb Loss
Medication
Nonsteroidal anti-inflammatory drugs (NSAIDs), prescription pain relievers, antidepressants, anti-seizure medications, beta blockers, or muscle relaxers may be prescribed to address pain and discomfort.
Neurostimulation
Neurostimulation for limb loss uses a small implanted device that sends gentle electrical messages to the nerves to disrupt pain and sensation signals that travel between the affected limb and the brain.
Physical Therapy
Tailored exercise programs assist in improving strength, flexibility, and overall functionality, helping individuals adapt to their changed biomechanics and optimize the use of prosthetic limbs.
Injections
Injections such as corticosteroids or botox may be used to target specific issues, such as inflammation and pain or muscle spasms.
Surgical Treatments for Limb Loss
Revision Surgery
Sometimes, the initial amputation surgery may leave residual tissue or scarring that causes discomfort, pain, or difficulty with prosthetic use. Revision surgery can help to correct these issues and provide a more functional residual limb.
Targeted Muscle Reinnervation (TMR)
TMR is a surgical technique that reassigns nerves from the amputated limb to nearby muscle groups. This allows the patient to control their prosthetic limb more intuitively and experience a greater sense of touch and proprioception.
Nerve Transfer Surgery
In cases where nerve damage or neuromas (painful nerve masses) occur after amputation, nerve transfer surgery can be performed to reroute nerves or remove neuromas to alleviate pain and improve sensory function.
Lengthening Procedures
For individuals with a very short residual limb, lengthening procedures such as bone transport or distraction osteogenesis may be considered to increase the length of the residual limb, making it more suitable for prosthetic attachment.
Tendon transfers
Tendon transfer surgeries can help restore lost function by redirecting and reattaching tendons to improve joint movement and prosthetic control.
Flap Procedures
In cases where the amputation site has poor tissue coverage or blood supply, flap procedures can be performed to provide additional tissue coverage and improve wound healing. The procedure involves transferring a section of tissue, along with its blood supply, from one part of the body (donor site) to another (recipient site).
Amputation Rehabilitation
Our amputation rehabilitation program offers comprehensive and personalized treatment designed to help individuals adapt to life after limb loss and optimize their physical, functional, and emotional well-being. Our multidisciplinary approach involves collaborating closely with various healthcare professionals, including physical therapists, occupational therapists, prosthetists, and psychologists, who work together to address the unique challenges faced by individuals who have undergone amputation.
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Frequently Asked Questions
Will I experience phantom limb sensations after amputation?
Phantom limb sensations are common, and while they may initially occur, they often decrease over time. Your healthcare team can provide strategies to manage them.
How soon can I start using a prosthetic limb after amputation?
The timeline varies, but prosthetic fitting typically begins once the residual limb has healed. Your prosthetist will work with you to determine the most suitable time for fitting.
Will insurance cover the costs of my prosthetic limb and rehabilitation?
Insurance coverage varies, but many plans include prosthetic services and rehabilitation. It's essential to check with your insurance provider to understand your coverage.
Will I be able to return to my usual activities after amputation?
With the right rehabilitation and support, many individuals can resume their usual activities, including work, sports, and recreational pursuits, after adapting to their new circumstances.
What long-term care considerations should I keep in mind after amputation?
Long-term care involves regular follow-ups with healthcare professionals, monitoring the condition of your residual limb, and staying attentive to overall health to ensure continued well-being and comfort.
What are the benefits of targeted muscle reinnervation?
Targeted muscle reinnervation allows patients to achieve a new level of function with prosthetic devices and an improved quality of life. While the journey to recovery can be long and demanding, patients are often able to resume many of their pre-amputation activities. For those undergoing immediate TMR, the risk of phantom limb pain or stump pain is significantly decreased. In delayed TMR cases, many patients experience relief of chronic pain.
Who may be a candidate for targeted muscle reinnervation?
Targeted muscle reinnervation may be performed at the time of an amputation (immediate TMR) or after an amputation (delayed TMR). An immediate TMR procedure has the ability to provide patients with improved prosthetic control and a quicker return to everyday life following an amputation. Patients who have undergone an amputation without TMR may be candidates for a delayed TMR procedure if they are experiencing difficulties with prosthetic control and/or tolerance. Delayed TMR procedures may also be performed to alleviate chronic pain following an amputation, such as phantom limb pain or stump pain.