Amputations on Elderly Patients

In some cases, it is necessary to remove infected or necrotic tissues from an elderly patient via amputation. Some of the conditions that make amputation necessary include diabetes mellitus and peripheral artery disease. In many instances, amputations are often a last resort and are only necessary to save the life of an elderly patient.

What Are the Most Common Amputations for Elderly Patients?

There are a number of different types of amputations for elderly patients. One of the most common categories is lower extremity amputations on one or both legs. However, amputations can occur on other parts of the body as well.

Partial foot amputations usually include  amputation of the distal foot and can also include amputation of the toes.

A transtibial amputation is performed at the upper to the middle third of the shin. In the event that the amputation takes place at a higher point, the surgeons will try to preserve the knee joint, as this will help the patient regain a more natural stride while walking.

A transfemoral amputation takes place on the mid thigh, and generally requires there be enough distance from the hip bone to allow for prostheses to fit later. These are not very common today and have been declining in use since around the 1980’s. It is becoming even rarer for elderly patients.

A partial hand amputation can refer to the fingertips or part of the fingertips. In the elderly, the thumb is the most common site of amputation. This can cause issues with the patient when it comes to grabbing and manipulating items. Metacarpal amputations require the removal of the entire hand, but the wrist will remain. Prosthetics can help the elderly amputee compensate for the lack of a hand. Wrist disarticulation is similar to a metacarpal amputation, save for the fact that the wrist is removed as well. Again, prosthetics can help. A transradial amputation is the partial removal of the arm from the middle of the forearm. The rehabilitation after this type of amputation can be difficult, and even using prosthetics can be difficult because they tend not to offer as much functionality for the patient.

What Are the Stages of Elderly Patient Amputations?

Amputations are a big decision, and there are a number of steps when it comes to this type of procedure. Understanding the steps is very beneficial and it can help to prepare as early as possible. The steps include:

  • Determining the type and the level of amputation
  • Making sure that the health status of the patient is sufficient for the amputation
  • Controlling pain in the limb
  • Offering preventative care for the area
  • Determining the right surgical techniques for the procedure in order to accommodate a prosthesis
  • Controlling pain
  • Wound treatment for the limb
  • Deal with issues of immobility
  • Post surgery shaping of the limb
  • Restoration of control for the patient
  • Maximization of treatment and improvement of nutrition
  • Determining the right type of prosthesis
  • Rehabilitation with the prosthesis
  • Planning for discharge
  • Help determining the roles of the family, the job, and housing

Recovery

There needs to be a set of goals for the patient after they go through the amputation procedure. It is important to understand the potential for rehabilitation and to create reachable goals. This can vary from simply regaining health to returning to an independent life. The doctors will look at the overall health condition of the elderly patient, including their muscle strength and cognitive abilities. Patients who are over 80 typically have a harder time recovering successfully but it is not impossible.

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