After a leg amputation, how should I look after my limb before a prosthesis?
A prosthesis is made for a limb whose wound has healed and whose swelling has settled. After surgery, the priorities are wound healing, managing swelling with compression as your medical team advises, and positioning so the knee and hip do not stiffen in a bent position. Recovery varies from person to person, so go through each step with your medical team.
Why is limb care the starting point for a prosthesis?
A prosthetic socket is shaped from a cast of your residual limb (the part of the leg that remains). If the cast is taken while the wound is still healing or the swelling keeps changing, the socket may loosen once the swelling goes down, or press on one spot and need refitting. Caring for the limb from the start is therefore part of getting a comfortable prosthesis.
What is common after surgery?
Everyone recovers differently, but after surgery many people experience the following.
- Pain and discomfort — usually easing over time with prescribed medication. Tell your doctor if it persists or gets worse.
- Warmth and swelling — normally settling gradually. If it does not, or increases, get it checked.
- Low mood — surgery, anaesthesia and adjusting to a changed body can all affect how you feel. Please talk to your medical team and family rather than carrying it alone.
- Phantom sensation and phantom pain — feeling that the missing leg is still there, or pain where it used to be. It is not unusual after amputation.
Phantom sensation can make you forget, for a moment, that the leg is gone and try to stand on it. Pause and move slowly when transferring between bed and chair. Ways of managing phantom pain are covered in our article on phantom limb pain and the mirror box.
How are healing and swelling managed?
Care after surgery has two strands: letting the wound heal, and preparing the limb into a shape that can take a prosthesis. The stitches may look healed on the surface while deeper tissue takes longer, and the timing depends on your overall health.
Most residual limbs swell for a while. To control swelling, compression with elastic bandages or a shrinker sock is commonly used in rehabilitation. How to wrap it and how long to wear it varies, so always follow your medical or rehabilitation team.
If the skin around the wound feels oversensitive, a gradual approach often suggested in rehabilitation is to start by stroking or gently tapping it with a soft cloth, within limits your medical team is happy with, so it slowly gets used to touch.
Which positions should I avoid?
Keeping the knee or hip bent for long periods can shorten the muscles and let the joint stiffen in a bent position (a contracture). That makes it harder to stand straight in a prosthesis later.
| Avoid | Instead |
|---|---|
| Resting the limb on a crutch handle | Keep crutches for support and let the limb hang straight |
| Letting the limb hang over the edge of the bed | Keep the whole leg on the bed, straight |
| Sitting on a bed or floor with a pillow under the bent knee | Support the whole limb so it lies in a straight line, not just under the knee |
After a below-knee amputation, keep the knee straight and the limb supported even when sitting — with a residual limb board on a wheelchair, or a second chair of similar height beside an ordinary one. If your medical team recommends it, lying on your front can also stretch the front of the hip. Our article on preventing joint contracture goes into more detail.
When can casting for a prosthesis begin?
The limb, not the calendar, sets the timing. Casting is considered once the wound has healed well and the skin and swelling are no longer changing much. Start with your medical team’s view, then check the limb together with your prosthetics clinic to agree when to start.
Even after you have your prosthesis, swelling can return during hours you are not wearing it, so some people continue compression as their medical team advises.
How does Silobionic approach this?
At Silobionic we look at your limb with you and check whether it is ready for casting. When it is, we put on a casting liner and take the cast, then confirm the fit with a check socket (a temporary trial socket) before completing the prosthesis. If it is still too early after surgery, we will tell you what to focus on in the meantime.
Frequently asked questions
Are pain and swelling normal after surgery?
Some pain and swelling are common after surgery and usually ease over time. If they persist or get worse, tell your doctor.
How long should I keep using compression bandages?
It varies from person to person. Follow your medical or rehabilitation team on how to wrap and for how long.
How soon after surgery can I be fitted for a prosthetic leg?
The limb sets the timing, not a date. Casting is considered once the wound has healed and the skin and swelling have settled, in discussion with your medical team.
Can I have a prosthesis made if I have phantom pain?
Phantom sensation and pain are not unusual after amputation and do not in themselves rule out a prosthesis. If symptoms are severe, speak to your medical team before going ahead.
