Information About Ankle Amputations
Ankle amputations, or disarticulation of the ankle, involves removal of the foot at the ankle while preserving the heel pad in a procedure known as Syme’s amputation.
This typically allows for the surgeon to remove the diseased or injured tissue while preserving the rest of the limb, without the use of prostheses. It also allows for the patient to put weight on the bottom of the foot and walk, stand, etc., to a limited extent.
Infected pressure sores can result in ankle amputations. Pressure sores (also known as bedsores, decubitus ulcers and pressure ulcers) are preventable breakdowns of the skin. The elderly nursing home population is very susceptible to developing bedsores.
Most nursing home residents are unable to move or have restricted movement. Elderly residents that are wheelchair bound or bedridden are not able to move or reposition their bodies and therefore cannot shift the pressure beds and wheels chairs place on parts of their bodies. As a result, pressure builds on certain parts of the body like the back of the head from a pillow or the sacrum/tailbone/low back, heels, elbows, shoulder blades from a bed mattress. Extended periods of pressure reduces the blood supply to these areas of the body which kills skin cells causing the to skin breakdown. Pressure sores develop when the skin breaks down.
Once the skin breaks down the pressure ulcer wound can get infected with sepsis (blood infection), gangrene, osteomyelitis (bone infection), joint infection, MRSA (bacterial infection) or necrotizing fasciitis (flesh-eating disease). In extreme cases where the infection is deep an amputation might be required to prevent the infection from spreading from the bedsore to the rest of the body.
Many surgeons make the incision directly to the bone, although some prefer controlled-depth incisions, where the anterior incision is performed first and dissection is carried down through the subcutaneous tissue to the deep fascia. This same incision is then made to dissect the plantar flap and the ankle joint is disarticulated. At this time, the surgeon must show great care in order to avoid inadvertently transecting the posterior tibial artery, veins, and nerve, as well as avoiding repeated buttonholing of the skin between the Achilles tendon and posterior skin such that the heel pad is not damaged. Once the flaps are created, the surgeon moves onto the resection of the fibula and tibia and, prior to closure, drill holes are placed in the anterior aspect of the tibia while the Achilles tendon and other remaining soft tissues are secured with sutures.
Healing tends to only be an issue in patients undergoing the amputation for peripheral vascular disease and/or diabetes-related reasons. However, complications can arise if the wound fails to heal, leading to infection and the need to potentially go back into surgery and amputate at a higher level on the leg. Therefore, patients must first be assessed for their ability to heal after the procedure. Patients must also be careful about excessive motion of the heel pad stump, as this can lead to ulcers.
The first several weeks after the amputation are critical, as this is when the wound is most at risk. The use of a surgical drain can help minimize any hematoma and seroma formation. Vascularity must also be maintained in the flap. Late complications can include stump sensitivity, phantom pain, and neuroma formation Phantom limb sensation is common, where patients have the sensation that the foot is still present. While this is somewhat common in all amputees, it is also possible with ankle amputations to develop nerve pain where major nerves were cut. If the patient does need a prosthetic, it can be difficult to produce one that is aesthetically appealing.
What Can You Do if You Suspect a Nursing Home is Liable for a Loved One’s Amputation?
Sometimes a nursing home is liable for your loved one’s injuries and their resulting complications, including death. When a nursing home neglects patient needs, including their medical needs related to bedsores, they may have committed a type of medical malpractice for which you can seek compensation.
If you believe your loved one has suffered a medical condition, amputation, or has died because of complications related to bedsores or other forms of nursing home neglect, contact our experienced and compassionate nursing home neglect lawyers today for a free consultation.
We offer a free, no-obligation legal consultation to help you understand your rights and the value of your case. Our personal injury law firm takes cases involving elder abuse and neglect. We offer legal service to clients in Massachusetts, Rhode Island and New Hampshire.
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