Causes

Peripheral AKA lower extremity occlusive disease. Atherosclerosis is the

Vascular Disease thickening or hardening of the arteries caused by a buildup of
plaque in the inner lining of an artery.
Intermittent Reproducible ischaemic muscle pain especially after physical
Claudication activity. Blood circulation is sufficient at rest.
Smoking Due to its effect on the circulation and potential for healing.
Detrimental effects on wound healing due to the local and
systemic processes that nicotine has
Diabetes Mellitus and 28% of people with a foot ulcer develop another foot ulcer within
Ulcers a year. people with DM have a 10 times higher risk of amputation
Trauma Amputation can take place at the site of the accident i.e. a direct
limb transection or may be due to severe open
fractures or severe neurovascular injuries. Examples of traumatic
injuries include compound fractures, blood vessel rupture, severe
burns, blast injuries, stab etc.
Infection Due to systemic infections such as bacterial infections. include
Meningococcal Meningitis, Staphylococcus a Necrotizing Fasciitis
etc. Rate may be higher in developing countries.
Tumors Bone- and cartilage-forming tumours (osteosarcomas and
chondrosarcomas) are rare malignant neoplasms. These tumours
are clinically aggressive and often need extensive local and/or
systemic treatment Amputation may be required in some cases.
In children Acquired : result of severe infection, cancer, trauma, or blood
vessel or nerve abnormalities. (not since birth)
Congenital (since birth): failure of formation. One of the causes
for congenital limb deficiency is said to be from an unexpected
drug reaction like with the thalidomide tragedy.

Complications
Phantom Limb A feeling of pain or sensations in the “missing limb” may
Pain occur; this is likely to be neuropathic and treatment is
generally with neuropathic pain medication such as
gabapentin and pregabalin
Residual Limb Musculoskeletal and localized in nature due to the
Pain remodelling of scar tissues, fascia, and muscles. Treatment
includes wound care and systemic medications such as
NSAIDs, Acetaminophen, opioids and in some cases muscle
relaxants. Desensitization techniques may also be used such
as compression, tapping, massage, and other modalities.
Edema Localized swelling is a complication that is very likely to
occur in amputations and has the best outcome when
control is started soon after surgery, with an immediate
post-operative rigid dressing. Edema can further be
controlled by compressive dressings, massage, elevation and
in patients who have comorbidities affecting fluid balance,
use of
diuretics
Contracture Contractures are a musculoskeletal condition causing rigidity
formation or hardening of muscles, tendons or other tissues leading to
deformity and rigidity of joints
Body Asymmetry An amputation creates weight distribution changes and can
modify the center of gravity leading to compensatory
mechanisms in function and gait, which can lead to pain,
spasms or discomfort in other areas of the body.
Skin breakdown Skin break down at the site of surgery can occur for a variety
of reasons including poor wound healing due to co-
morbidities, excessive bleeding, infection, edema, and poor
dressing techniques. In the long term, this complication may
arise due to assistive devices or prostheses.
Neuroma Over time, as nervous tissue remodels, a mass of soft tissue
and nerves may form. These are often benign but can be
painful. Conventional treatments may include neuropathic
pain medications or nerve blocks