Losing a limb or facing an amputation can be a traumatic and life-altering experience.

At The Ohio State University Wexner Medical Center in Columbus, Ohio, we view amputation as an alternative form of limb reconstruction, not as a failure. Our goals are to give you as much function as possible and to minimize pain. We approach amputation with the same dedication and sophistication that we devote to limb-salvage care. We can leverage new techniques and technology to exceed the function offered by an intact but damaged limb.

Our specially trained surgeons and pain and rehabilitation doctors not only excel at advanced amputation techniques, but in many cases, they helped develop the procedures. Very few medical centers nationwide have the breadth and depth of amputation options available that we do. Our collaborative approach to amputation care will set you up for success following a new amputation or help you overcome challenges from an amputation performed elsewhere.

When you’ve been told elsewhere, “There’s nothing we can do,” that’s where we specialize. While there aren’t always easy solutions for your amputation-related issues, we’re committed to working with you to explore all options. It would be our privilege to partner with you on your limb-loss journey.

Why choose Ohio State for advanced amputation care?

Amputation care at the Ohio State Wexner Medical Center is approached with an entirely different mindset than the care commonly found elsewhere. We view amputation as the start of a new chapter, not the disappointing end of a limb salvage journey or the unfortunate consequence of a cancer diagnosis or another circumstance such as a traumatic accident.

We are excited to help you exceed your own expectations — and the expectations of others — following limb loss, and we’re committed to working with you to achieve the quality of life you deserve.

Key differentiators in our Advanced Amputation program include:

Expertise not available elsewhere

Our expert surgeons helped develop the very advanced techniques that are helping to improve the lives of those with amputations around the world. For example, Ohio State has one of the largest osseointegration practices in the United States, and we perform specialty procedures, like targeted muscle reinnervation and microsurgical soft tissue resurfacing, on a weekly basis. We’ve helped people who haven’t been able to walk for decades achieve independence and a new outlook on life.

Truly collaborative care

Our plastic surgeons work very closely with our orthopedic and vascular surgeons to ensure limb preservation when possible and to teach best practices when amputation is recommended. A thoughtful, well-done amputation is critical to successful recovery and rehabilitation following amputation and may limit the need for more advanced surgical interventions down the road. Our Military Medicine Program showcases just how effective this multidisciplinary care can be.

Strong focus on survivorship

At Ohio State, those undergoing an amputation or already living with limb loss can expect to have a full continuum of care at their disposal — from pre-amputation education to dedicated rehabilitation and limb-loss-specific-therapy. They’ll have access to advanced interventional and surgical strategies at all points along the way. We work collaboratively with specialists in amputation rehabilitation, prosthetics, pain management, mental health care and many others to ensure the holistic care required to thrive after limb loss.

Research and innovation

Just as many of Ohio State’s nerve experts have been at the forefront of developing some of the most advanced amputation techniques, they’re also continuing to research and push forward better and more efficient ways to improve the lives of those with amputations.

What causes the need for amputation?

People face an amputation for a variety of reasons, including for certain diseases or injuries. There are two types of amputations:

• Surgical amputation – This occurs when a body part is removed by a surgeon to prevent the spread of disease or to relieve pain and improve function after injury.
• Traumatic amputation – This occurs when a body part is severed by an accident or injury, such as a car crash, explosion or combat injury.

Conditions that could cause the need for an amputation include:

• Diabetes
• Vascular conditions, such as peripheral artery disease or blood clots
• Cancer, such as sarcoma, melanoma or osteosarcoma
• Congenital conditions that cause missing or deformed limbs at birth
• Trauma, such as car accidents, falls, gunshot wounds, burns, frostbite, electric shock, animal attacks or crush injuries

You might benefit from our advanced amputation care if:

• You’re considering amputation due to pain or lack of function
• You’re recommended amputation because of cancer or another chronic condition     
• You’ve had an amputation — even if it was years ago — and you experience phantom limb pain, residual limb pain, wounds, sores or socket-related discomfort or other post-amputation complications
• You’ve had an amputation and want better function, including those who have never used a prosthetic device but would like to

How is limb-loss surgery performed at Ohio State?

Amputation surgery at Ohio State is done with the utmost care and sophistication, often by our most highly skilled surgeons. It usually requires at least an overnight stay, sometimes longer if other procedures to improve function are being done at the same time.

Before the surgery, you’ll be given all the information you need to make informed decisions about your care, and you’ll know what to expect. What happens during limb-loss surgery can vary, depending on what part of the body is being amputated, the reason why and whether other procedures will be done.

Generally, however, steps to an amputation include:

• Removing the limb and any affected tissue and bone
• Smoothing the severed bone
• Closing off any blood vessels to prevent bleeding
• Covering the residual limb with skin and shaping the stump to make it fit properly with a prosthesis
• Dressing the wound with sterile bandages

Often, we will perform advanced techniques, such as osseointegration, targeted muscle reinnervation, agonist-antagonist myoneural interface (nerve/vessel/muscle repositioning) and soft-tissue revision, at the same time as amputation to improve outcomes.

Amputation-related procedures

Because of the high level of care available at Ohio State, we’re able to offer procedures not done elsewhere. Our plastic and orthopedic surgeons are pioneers in many of these techniques and do more of these types of surgeries than most hospitals around the world.

Nerve damage reconstruction

Our doctors treat all types of nerve injuries, including cut, compressed or crushed nerves in your face, shoulders, arms, legs and other parts of the body.

Targeted muscle reinnervation (TMR)

TMR relieves pain and improves function by redirecting painful, abnormal nerves and nerve growth after injury or amputation. Surgeons reroute cut or damaged nerves and severed nerve endings into motor nerves in nearby muscle. Surgeons can perform TMR during an amputation or weeks and even years later.

Osseointegration

After amputation, surgeons place a metal implant in the remnant limb. This two-part procedure may be part of an amputation or done later to relieve painful post-amputation complications. Osseointegration improves the stability, comfort and function of an artificial limb. Once the metal implant bonds with bone tissues within a few months, doctors perform residual limb optimization.

Residual limb optimization

After amputation, surgeons shape the remaining limb for form and full soft-tissue coverage, protection and comfort. They customize a smooth, tailored fit for the prosthesis.

Soft tissue revision

This surgery corrects post-amputation complications such as skin irritation, infection, pinched nerves, painful scars and prosthesis discomfort. Surgeons treat damaged nerve endings and bone tissue while reshaping the limb remnant to enhance fit.

Agonist-antagonist myoneural interface

By linking together certain muscle pairs, surgeons can restore proprioception, which is the body’s ability to sense where it is and how it’s moving without looking. Restoring this sense allows people with an amputation to more precisely control the movements of their artificial limb and have a better overall quality of life.

Risks of amputation and other nerve procedures

Multiple traumatic injuries and conditions such as diabetes, heart disease or infection increase the chance of complications after limb-loss surgery. Clotting risks may increase due to postoperative immobility. Additional risks include:

• Deep tissue infections
• Bone fracture
• Hematoma
• Implant bending or breaking
• Joint deformity
• Local skin infections
• Muscle pain
• Pressure ulcers
• Skin flap necrosis
• Wound reopening