[Errors and complications associated with lower limb amputation]. / Fehler und Komplikationen bei Amputationen an der unteren Extremität.

ABSTRACT

BACKGROUND: The newly launched "German law of patients' rights" strenghthens the rights of patients and places special emphasis on the right to full information. This includes information on errors, mistakes and complications due to surgery. ASSESSMENT Surgery complications and mistakes are of main importance especially in the area of amputation because rehabilitation chances are dependent on good surgical quality. Therefore, it is necessary that surgeons know about these problems. Complications may be hematomas, bleeding, dysvascular problems, skin- or muscle-necrosis, and infections and wound healing problems, as well as neuromas or calcification of soft tissues. They are not totally preventable. CONSEQUENCES Surgical mistakes may involve insufficient shaping of the bony stump end, incorrect treatment of soft tissue, wrong decisions regarding the amputation level, insufficient treatment of nerves and wound closure under tension of soft tissue. All surgical mistakes negatively influence the end-bearing capability of the stump and, therefore, the prosthetic fit, and with this reduce rehabilitation chances. PURPOSE: It is necessary that surgeons know about these problems in order to avoid them. Therefore the typical complications and errors are demonstrated with case reports.