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Crowe et al. Plast Aesthet Res 2019;6:4 Plastic and
DOI: 10.20517/2347-9264.2018.70 Aesthetic Research

Review Open Access

Prosthetic and orthotic options for lower extremity
amputation and reconstruction

Christopher S. Crowe , Kate A. Impastato , Alex C. Donaghy , Caryn Earl , Janna L. Friedly , Kari A. Keys 1
3
2
2
1
1
1 Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA 98104,
USA.
2 Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA.
3 Prosthetics and Orthotics Clinic, Harborview Medical Center, Seattle, WA 98109, USA.
Correspondence to: Dr. Christopher S. Crowe, Division of Plastic Surgery, Department of Surgery, University of Washington School of
Medicine, 7CT73.1 Harborview Medicine Center, 325 9th Avenue, Mailstop #359796, Seattle, WA 98104, USA.
E-mail: ccrowe2@uw.edu

How to cite this article: Crowe CS, Impastato KA, Donaghy AC, Earl C, Friedly JL, Keys KA. Prosthetic and orthotic options for lower
extremity amputation and reconstruction. Plast Aesthet Res 2019;6:4. http://dx.doi.org/10.20517/2347-9264.2018.70

Received: 29 Sep 2018 First Decision: 8 Oct 2018 Revised: 1 Feb 2019 Accepted: 1 Feb 2019 Published: 27 Feb 2019

Science Editor: Matthew L. Iorio Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract

Lower extremity injury and deformity can result from a number of etiologies. Regardless of the underlying cause, the
decision to pursue amputation or reconstruction of a lower limb is challenging for both patients and practitioners.
This decision is largely dependent on the patient’s premorbid health and function, functional goals and preferences,
and characteristics and viability of the affected limb. The role of adaptive devices following surgery should never be
underestimated. Advances in prostheses and orthoses have provided patients with a wider range of options to consider
when deciding between limb reconstruction and amputation. The primary goals of any adaptive device are to improve
function, prevent recurrence or ulceration of the defect, and allow for use of conventional footwear and/or clothing.
When a lower extremity amputation is indicated, selection of the correct level is of critical importance in order to optimize
healing potential and function. Each distinct level has certain inherent prosthetic and orthotic considerations. Likewise,
the application of an adaptive device following reconstruction of the lower extremity also has demonstrable benefits and
must be tailored to the specific defect and procedure performed. Knowledge of available prosthetic and orthotic options
is of considerable importance for the reconstructive surgeon tasked with limb salvage or resurfacing an amputated
extremity. This article reviews considerations of various types of lower extremity amputation and reconstruction, and
provides a framework for the role of adaptive devices following surgery.

Keywords: Prosthesis, orthosis, amputation, reconstruction, rehabilitation, lower extremity

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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