Current state of knowledge garding lower limb amputations: new advances in surgery

Abstract

Against the background of the growing number of local and international armed conflicts, in particular the full-scale war in Ukraine, cases of severe injuries accompanied by traumatic loss of lower limbs are increasingly being recorded. In peacetime, the main causes of amputations were vascular pathologies, diabetes mellitus and malignant neoplasms, however, combat trauma is now becoming increasingly important. Amputation of the lower limb, regardless of etiology, is a surgical intervention with a high risk of complications, significant functional consequences and the need for complex rehabilitation. In this context, it is extremely relevant to study the current state of knowledge in the field of amputation surgery, in particular regarding the latest techniques, predicting complications and ensuring the quality of life of patients. The aim of the study is to summarize current scientific information on surgical approaches to lower limb amputations, associated complications and prospects for improving the quality of life of patients. Materials and methods. To achieve the goal, a systematic review of publications in leading scientometric databases (PubMed, Scopus, Web of Science) over the past 10 years was conducted. The review covered studies devoted to surgical techniques, reconstructive technologies, postoperative complications and social adaptation of persons with amputated limbs. Results of the study. Today, considerable attention is paid to the use of gentle amputation techniques taking into account the preservation of the functional capabilities of the hip and knee joints, which significantly facilitates future prosthetics. The latest surgical strategies are being implemented in practice, such as targeted muscle reinnervation, osseointegrated prostheses, bioelectric control and 3D printing of individual components. At the same time, the frequency of complications such as phantom pain, soft tissue infections, stump healing disorders, depression and posttraumatic conditions remains high. The quality of life after amputation largely depends on access to modern prosthetics, early initiation of physical rehabilitation, psychological support, and social integration. Conclusion. Modern amputation surgery is rapidly evolving due to the introduction of technological innovations and interdisciplinary approaches. Effective postoperative management and comprehensive rehabilitation are key factors in reducing disability and improving the quality of life of patients.