How Does Your Residual Limb Change After Amputation?

After an amputation, you may notice changes in your residual limb. It’s important to be familiar with the most common residual limb changes, and how you can address your concerns with your doctor and your prosthetist.

After your amputation surgery, you may experience discomfort, challenges with dressing and cleaning your wound, and disorientation with the way your stump feels. These are all normal challenges, and most patients are able to adjust fairly quickly.
There are also natural changes to residual limbs that may surprise or upset many recent amputees. Most of the time, these changes are completely normal. Sometimes, they are cause for concern.
Here are the most common changes in residual limbs after amputation, and how you can address them. 

Changes in Stump Shape and Volume

In the first 12-18 months after amputation, your residual limb will undergo a number of changes in size and shape. Residual limb volume, in particular, changes a lot as you heal from your amputation.

Some studies show that residual limbs can decrease in volume by anywhere from 17% to 35% in the first few months after amputation surgery. These size fluctuations can make rehabilitation and prosthetic socket fitting challenging, especially if an amputee is also exercising less without altering his diet. 

Many changes in the volume of your residual limb are natural side effects of limb loss.

Stump shrinkage, for instance, happens as postoperative muscle atrophy sets in. This occurs because you are using your residual limb far less than you used your full limb before surgery. Shrinkage should stabilize almost completely within 6-8 months after amputation.

Another source size fluctuation is a residual limb is 
post-operative edema. Edema is swelling that results from excess fluid in the residual limb’s soft tissues. It is important for new amputees to control edema by using compression or shrinker socks for the first 12-18 months after amputation. Individuals using compression or shrinker socks should remove them several times a day to check for skin breakdown and wounds.

It is also important to establish a post-amputation exercise routine to control weight gain. Many amputees naturally move less after surgery, due to pain from healing, new mobility issues and psychological adjustments. However, weight gain impacts the size of your residual limb the same way it does the rest of your body. This can cause fit issues with your prosthetic socket and can lead to irritation, skin breakdown and setbacks in your post-amputation rehabilitation.

Talk to your physical therapist or rehabilitation team for ideas on maintaining an adequate activity level to prevent weight gain after your surgery.

Skin Problems

Many amputees experience skin problems, wounds and infections after surgery. This is especially true if the patient has diabetes, vascular disease or other illnesses that cause slower wound healing.

For diabetics, good post-amputation wound care is imperative. If you have diabetes, it is vital to check your stump several times a day for sores, wounds or other signs of infection.

While compression or shrinker socks are important to aid in stump size adjustment, they can also cause sores, blisters or skin breakdown if they aren’t continually monitored. Untreated stump wounds can lead to serious infection and may require hospitalization.

After your amputation, it is vital to carefully clean your surgical wound multiple times per day using a mild soap and clean water. Pat your wound dry using a gentle cloth. Avoid soaking your stump, as it can lead to skin breakdown.

Check your stump daily for signs of rubbing, irritation, blisters, redness or sores. If you develop any of these skin problems after your amputation, you should visit your doctor immediately. You may need a different limb sock or a different socket fitting to alleviate these problems.

Muscle Contractures

Muscle contracture is the semi-permanent or permanent limitation of movement in the soft tissues. It is caused by shortening or stiffening of the muscles, tendons, ligaments and skin that is in close proximity to your residual limb. Above-the-knee amputees can experience hip flexion contracture, while below-the-knee amputees can experience knee flexion contracture. Muscle contracture in an amputee poses many challenges, including painful rehabilitation, slowed rehabilitation and issues wearing and using a prosthetic device.

Post-amputation contracture is typically caused by extended immobility of the residual limb and surrounding soft tissues and structures. Many amputees have suffered from mobility problems for a long time before amputation, so they may not know how important it is to exercise, stretch and maintain movement in their residual limbs.

It’s important not to lie in bed for long periods of time following amputation.

Transtibial amputees should avoid lying with the residual limb hanging over the edge of a bed or with the knees flexed. They should also avoid lying with a pillow under the knees. Transfemoral amputees should avoid lying with pillows under the thigh. For all amputees, regular stretching and exercising of the muscles near the residual limb is imperative to help avoid post-amputation contractures.

If you aren’t sure about exercises and activities that can help you, talk to your physical therapist or rehabilitation team. They will have creative exercises that are comfortable on your body but provide you with the activity you need to avoid issues with your muscles, tendons and ligaments after your amputation.

Amputation Support at FIT Prosthetics in Salt Lake

As you adjust to life after limb loss, it’s important to have resources available to help you navigate the changes, challenges and questions you’ll face along the way.

FIT Prosthetics offers a full range of support resources for amputees, including pre-amputation evaluation, custom and ongoing prosthetic fittings, delivery and more.

Contact us today to learn more!