Major lower limb amputation – what, why and how to achieve the best results

This article is intended as an overview of rehabilitation following major lower limb amputation; which surgical techniques can improve outcomes, why they should be considered and how the rehabilitation team works once patients have left the care of the surgical team. It is aimed primarily at orthopaedic and trauma surgeons, but also contains references to dysvascular patients, as this is the primary cause of lower limb amputation in the UK. The different aspects of rehabilitation after an amputation will be presented using the World Health Organization’s international classification of functioning, disability and health. The domain of health condition includes the aetiology of amputation and a brief history of prosthetic provision. The impairment section covers surgical techniques and how they can help improve outcomes for patients along with pre and post-operative pain management. An activity section contains an introduction to physiotherapy and early walking aids, with an overview of prosthetic assessment and the common component types. The participation section goes into appropriate goal setting and realistic outcomes that patients can expect. The final section on social and environmental factors briefly covers psychology and motivation. A vignette of key learning points concludes the article.