Stump Revision Surgery: Its Advantages and When it is Recommended

An overview:

Amputation is the surgical removal of a limb, finger, or toe — necessary if that part has undergone any significant trauma or infection. 

The remaining part or residual limb is called the stump. The stump may shrink or change in shape by wearing an external prosthesis that causes discomfort. The aim of all stump revision surgery is the relief of pain. Pain prevents proper mobilisation, can reduce activity and impair function and reduce quality of life. A stump revision surgery aims to recreate a suitable residual limb structure for properly fitting a permanent prosthesis and producing a prosthetic limb to allow you to perform a range of activities with the new limb.

How is stump revision surgery done?

A removable prosthesis does not require surgery, but some people find difficulty in wearing the socket, possibly because of the shape change of the stump, instability of the removable prosthesis, or continuous pain by wearing an external prosthesis.  These limitations of external limbs  may encourage people to choose stump revision surgery. 

It is important to correctly address the source of the individual’s pain. This may be from the soft-tissues, nerves or the bones. 

Both inadequate and  excess soft-tissue may interfere with wearing a prosthetic and produce pain. Nerves may produce painful neuromas. These may be best addressed by way of a Targeted Muscle Reanimation procedure. Other issues may be painful bursae around the end of the bone. 

For some patients, the residual limb may be too short to retain a prosthesis, or simply have too little soft-tissue to prevent pressure sores. For these patients, they may opt for an osseointegrated prosthesis. . 

Osseointegration of a prosthesis is a technique to permanently fix the prosthesis into the bones of the residual limb. The osseointegrated bone anchor into the prosthetic limb, and the amputation specialist ensures the stability of the newly formed limb. 

Advantages of the permanent osseointegrated prosthesis over the removable prosthesis

The osseointegrated prosthesis is a permanent fixture that provides significant functional advantages to the patient, such as 

• Improved appearance of the stump
• No need to wear and remove the external prosthesis
• Negligible chances of stump’s physical changes
• A normal limb feel
• Increased range of motions
• More reliable prosthesis solution from the stability point of view.

When is stump revision surgery indicated?

 It is indicated for:

• Residual limb pain
• Folliculitis infections 
• Severe bursae inflammation due to trauma or infection
• Cyst development
• Development of heterotopic bones or extraskeletal bones
• Constant anatomical changes in stump
• Deterioration of stump socket or its ulceration
• Psychological trauma due to the unattractive appearance of an amputated limb.
• Pain while wearing external prosthetics due to extra soft tissue prevents wearing a prosthetic socket. 

It is essential to consult a highly experienced prosthetist for stump revision surgery to ensure no problems remain with the prosthetic limb, socket, and stump. It is also important that the patients should be able to benefit optimally from the stump revision surgery and also get relief from residual limb pain. 

The amputation specialist advises you to have realistic expectations from the surgery. You may have blood loss and pain after the procedure. Dr Demetrius will recommend you use a wheelchair and avoid using the stump leg until it heals.

It can take 6 and 12 weeks to get accustomed to the new leg and develop a walking gait. 

The ultimate aim of surgery is to facilitate a better-fitting prosthesis capable of bearing body weight and mimicking natural limb functioning.

Why choose Dr Demetrius for your stump revision surgery?

Dr Demetrius Evriviades, who heads the Amputee Pain Clinic, is a revered reconstructive plastic surgeon in the UK with a thorough 20 years of experience in amputation rehabilitation. He also publishes research data in osseointegration. 

With a spotless track record of highly successful osseointegration stump revision surgery, he is one of the most in-demand amputee specialists in Dubai. 

Feel free to contact Dr Demetrius for your amputation issues.