Residual Limb Complications and Management Strategies

Major extremity amputations due to any cause are fraught with potential and overt complications, ranging from infection and heterotopic ossification to phantom neuropathic pain and symptomatic neuromata. Prevention of issues such as bursa formation and skin irritation or ulceration through intimate, comfortable prosthetic socket fit, and diligent skin care are crucial and vastly preferred to managing the sequelae of same. For most issues other than deep infection, a trial of non-operative modalities is indicated prior to any operative intervention, as conservative management is often successful. For patients with persistently symptomatic residual limbs and an identifiable cause, focal or complete operative revision can be highly successful at alleviating symptoms and improving patient prosthetic tolerance and function. A multi-disciplinary approach from an integrated rehabilitation team is critical to the successful management of these challenging and rewarding patients.