Editing Amputation (section)

== Trauma ==
Traumatic amputation is the partial or total avulsion of a part of a body during a serious accident, like traffic, labor, or combat.<ref>{{Cite book |url=https://accessmedicine.mhmedical.com/book.aspx?bookid=675 |title=Current Diagnosis & Treatment in Orthopedics |vauthors=Smith DG, Skinner HB |date=2014 |publisher=McGraw-Hill Education. |isbn=978-0-07-159075-4 |veditors=Skinner HB, McMahon PJ |edition=5th |chapter=Amputations |chapter-url=https://accessmedicine.mhmedical.com/content.aspx?bookid=675&sectionid=45451717}}</ref><ref name="Watson1986">{{Cite book |title=Hand Injuries and Infections |vauthors=Watson N |publisher=Gower Medical |year=1986 |isbn=0906923808 |location=London}}</ref>

Traumatic amputation of a human limb, either partial or total, creates the immediate danger of death from blood loss.<ref>{{Cite journal |vauthors=Ramirez C, Menaker J |date=2017-05-01 |title=Traumatic Amputations |url=https://www.reliasmedia.com/articles/140552-traumatic-amputations |journal=Trauma Reports |volume=18 |issue=3}}</ref>

Orthopedic surgeons often assess the severity of different injuries using the Mangled Extremity Severity Score. Given different clinical and situational factors, they can predict the likelihood of amputation. This is especially useful for emergency physicians to quickly evaluate patients and decide on consultations.<ref>{{cite journal | vauthors = Johansen K, Daines M, Howey T, Helfet D, Hansen ST | title = Objective criteria accurately predict amputation following lower extremity trauma | journal = The Journal of Trauma | volume = 30 | issue = 5 | pages = 568–72; discussion 572–3 | date = May 1990 | pmid = 2342140 | doi = 10.1097/00005373-199005000-00007 | doi-access = free }}</ref>

===Causes===
[[File:3372709503 10dc75d783 oSéquelleAmputation.jpg|thumb|170px|Private Lewis Francis was wounded July 21, 1861, at the [[First Battle of Bull Run]] by a bayonet to the knee.]]
Traumatic amputation is uncommon in humans (1 per 20,804 population per year). Loss of limb usually happens immediately during the accident, but sometimes a few days later after medical complications. Statistically, the most common causes of traumatic amputations are:<ref>{{Cite web |date=2017-10-17 |title=Amputation |url=https://www.nhs.uk/conditions/amputation/ |access-date=2022-09-07 |website=nhs.uk |language=en}}</ref>
* Vehicle accidents (cars, motorcycles, bicycles, trains, etc.)
* Labor accidents (equipment, instruments, cylinders, chainsaws, press machines, meat machines, wood machines, etc.)
* Agricultural accidents, with machines and mower equipment
* Electric shock hazards
* Firearms, bladed weapons, explosives
* Violent rupture of ship rope or industry wire rope
* Ring traction (ring amputation, de-gloving injuries)
* Building doors and car doors
* Animal attacks
* Gas cylinder explosions<ref>{{Cite magazine |date=February 2011 |editor-last=Davison |editor-first=Ben |title=Scuba Tanks as Lethal Weapons |url=https://www.undercurrent.org/UCnow/dive_magazine/2011/LethalWeapons201102.html |url-status=live |magazine=Undercurrent |publication-place=Sausalito, California |volume=26 |issue=2 |pages=8–9 |archive-url=https://web.archive.org/web/20210428060005/https://www.undercurrent.org/UCnow/dive_magazine/2011/LethalWeapons201102.html |archive-date=2021-04-28 |access-date=28 June 2021}}</ref>
* Other rare accidents<ref>{{Cite journal |last1=Clasper |first1=Jon |last2=Ramasamy |first2=Arul |date=2013 |title=Traumatic amputations |journal=British Journal of Pain |volume=7 |issue=2 |pages=67–73 |doi=10.1177/2049463713487324 |issn=2049-4637 |pmc=4590129 |pmid=26516502}}</ref>

===Treatment===
The development of the science of [[microsurgery]] over the last 40 years has provided several treatment options for a traumatic amputation, depending on the patient's specific trauma and clinical situation:<ref>{{Cite journal |last1=Yoo |first1=Hyokyung |last2=Kim |first2=Byung Jun |date=2021-07-27 |title=History and Recent Advances in Microsurgery |url=https://synapse.koreamed.org/articles/1147742 |journal=Archives of Hand and Microsurgery |volume=26 |issue=3 |pages=174–183 |doi=10.12790/ahm.21.0097|doi-access=free }}</ref>
* 1st choice: Surgical amputation - break - prosthesis
* 2nd choice: Surgical amputation - transplantation of other tissue - plastic reconstruction.
* 3rd choice: [[Replantation]] - reconnection - revascularisation of amputated limb, by microscope (after 1969)
* 4th choice: Transplantation of cadaveric hand (after 2000)<ref name="Watson1986" />

===Epidemiology===
[[File:In Khmelnytskyi, the President Paid a Visit to the Warriors Recovering from Wounds and Presented Them with Awards. (53698029200).jpg|thumb|Up to 50,000 Ukrainians lost their limbs during the [[Russian invasion of Ukraine]].<ref>{{cite news |title='A new life': Ukrainian war amputees travel to Germany for custom-made limbs |url=https://edition.cnn.com/2024/06/03/europe/ukraine-soldiers-germany-prosthetic-limbs-intl-cmd/index.html |work=CNN |date=3 June 2024}}</ref>]]
* In the United States in 1999, there were 14,420 non-fatal traumatic amputations according to the [[American Statistical Association]]. Of these, 4,435 occurred as a result of traffic and transportation accidents and 9,985 were due to labor accidents. Of all traumatic amputations, the distribution percentage is 30.75% for traffic accidents and 69.24% for labor accidents.<ref name="amstat.org">{{Cite web|url=https://www.amstat.org//|title=American Statistical Association (ASA)|website=www.amstat.org}}</ref>{{Nonspecific|date=June 2021}}
* The population of the United States in 1999 was about 300,000,000, so the conclusion is that there is one amputation per 20,804 persons per year. In the group of labor amputations, 53% occurred in laborers and technicians, 30% in production and service workers, 16% in silviculture and fishery workers.<ref name="amstat.org"/>{{Nonspecific|date=June 2021}}
* A study found that in 2010, 22.8% of patients undergoing amputation of a lower extremity in the United States were readmitted to the hospital within 30 days.<ref>{{Cite journal |vauthors=Weiss AJ, Elixhauser A, Steiner C |date=April 2013 |title=Readmissions to U.S. Hospitals by Procedure, 2010 |url=https://hcup-us.ahrq.gov/reports/statbriefs/sb154.jsp |journal=HCUP Statistical Brief |issue=154 |publisher=[[U.S. Agency for Healthcare Research and Quality]] |pmid=24006552 |publication-place=Rockville, Maryland}}</ref>
* In 2017, an estimated 57.7 million people globally were living with existing traumatic limb injuries. Of these 57.7 million, the leading causes of amputation "were falls (36.2%), road injuries (15.7%), other transportation injuries (11.2%), and mechanical forces (10.4%)."<ref>{{Cite journal |last1=McDonald |first1=Cody L. |last2=Westcott-McCoy |first2=Sarah |last3=Weaver |first3=Marcia R. |last4=Haagsma |first4=Juanita |last5=Kartin |first5=Deborah |date=2021-04-01 |title=Global prevalence of traumatic non-fatal limb amputation |url=https://pubmed.ncbi.nlm.nih.gov/33274665/ |journal=Prosthetics and Orthotics International |volume=45 |issue=2 |pages=105–114 |doi=10.1177/0309364620972258 |issn=1746-1553 |pmid=33274665}}</ref>
* On 2 August 2023, an investigation by ''[[The Wall Street Journal]]'' found that Ukrainian medical amputations in the war came to between 20,000 and 50,000 including both military and civilians. In comparison, during [[World War One]] 41,000 British and 67,000 Germans needed amputations.<ref>{{cite web |url=https://www.businessinsider.com/amputations-ukraine-levels-not-seen-since-world-war-i-report-2023-8 |title=Amputations in Ukraine are as widespread as in the trenches of World War I due to Russia's heavy use of mines and artillery: report |date=2 August 2023 |last=Porter |first=Tom |work=[[Business Insider]]}}</ref>
* In 2024 [[Gaza Strip|Gaza]] was the site of the most child amputees in the history.<ref>[https://www.aljazeera.com/program/the-stream/2024/7/2/the-amputee-crisis-in-the-war-on-gaza The amputee crisis in the war on Gaza], 2 Jul 2024</ref>