Nothing can prepare a person for the trauma of losing an extremity. Many of the legal cases we deal with are caused by severe car crashes, tractor-trailer accidents, nursing home neglect, and dangerous work environments.
Amputations can be a painful procedure to endure and recover from. The amputee’s life will change in significant ways that may impact their ability to work and thrive.
Contact Gary Martin Hays & Associates if you have undergone an amputation or limb salvage operation due to someone else’s negligence or unsafe decisions. Read on for what to do if someone’s limb or digit is crushed or severed, amputation complications, and your legal options to receive much needed financial compensation and medical care.
Types of Amputation
About 110,000 amputations are conducted each year in the United States — more than 90% of those are lower limb amputations. Other kinds of amputations include:
- Above-elbow amputation (transhumeral)
- Above-knee amputation (transfemoral)
- Amputation of digits (Ray’s)
- Ankle disarticulation (Syme’s)
- Arm amputation
- Below-knee amputation (transtibial)
- Elbow disarticulation
- Forearm amputation (transradial)
- Hemipelvectomy (transpelvic)
- Hip disarticulation
- Knee disarticulation/through-knee amputation
- Leg amputation
- Metacarpal amputation
- Partial foot amputation (transmetatarsal, Lisfranc’s, or Chopart’s)
- Shoulder disarticulation and forequarter amputation
- Toe amputation
- Wrist disarticulation
Definition: Disarticulation - the separation of two bones at their joint, either traumatically by way of injury or by a surgeon during arthroplasty or amputation.
Amputations and Crush Injuries Due to Car Accidents
Although vehicle safety has increased significantly over the past couple of decades, violent collisions still occur daily. An amputation may be necessary due to a severe injury or serious burns sustained due to a car accident.
There have also been cases where a person was hurt because of a wreck and their wounds become infected. A serious infection can lead to gangrene and tissue necrosis, necessitating their removal.
Most of these crashes are caused by one of several factors:
- Drunk drivers
- Distracted drivers
- Large truck accidents
Violent car accidents can cause crushed limbs in a variety of ways depending on how the vehicle was struck. Arms can get stuck between the seat and door, legs can become trapped beneath the dashboard, or a pedestrian’s body can be smashed between two cars or a vehicle and a wall.
Amputations and Crush Injuries Caused by Work Accidents
Each year, more than 125,000 workers suffer crush injuries. A crush injury is when a part of the body is caught or stuck between two objects, or entangled in machinery. These hazards are sometimes referred to as “pinch points.”
A person caught in a pinch point or machine may only suffer scrapes and bruises if they are lucky. In some cases, getting trapped by an object can lead to amputation, mangling, and even death.
Crush injuries can be caused by a variety of things at a worksite, including:
- Becoming pinning between two objects
- Being hit by a falling object
- Being run over by machinery, equipment or a vehicle
- Equipment or machine falling over
- Limbs getting caught in machinery
- Machinery defects
- Structural collapses
When the body is crushed with such force cells begin to die immediately due to cell disruption, lactic acid generated by damaged muscles, and lack of blood flow. Crush injuries often see severe damage to muscles, nerves, skin, bone, and other organs. A crush victim may need amputation, become paralyzed, or die as a result of their injuries.
The severity of the damage will depend on how much force was generated by the crush, the body part involved, and how long the person was stuck between the two objects. Usually, the extremities like hands, feet, arms, and legs are involved, but any part of the body can be involved in an accident that causes a crush injury.
How to Treat a Crush Injury
A person with a crush injury may experience one or more different types of damage, including bleeding, bruising, compartment syndrome (intense pressure that causes serious muscle, nerve, blood vessel, and tissue damage), fractures, lacerations (open wounds), nerve injury, and infection.
Here are the steps for crush injury first aid:
- Stop the bleeding by applying direct pressure.
- Cover the area with a damp cloth or bandage and raise it above the heart if possible.
- If there’s a possible head, neck or spinal injury, immobilize these areas.
- Call 911 for an ambulance and further advice.
In some cases, it may not be possible to remove a crushed person. Stay with them and wait for emergency services to arrive.
Can a Crushed Limb Be Salvaged?
Limb salvage is a term used when a limb is horribly damaged but is still somewhat functional. Recent medical advancements have made it possible to reconstruct severely injured body parts, although it requires multiple surgeries to do so.
Sometimes a person may be faced with the choice of whether to save their limb or amputate. Reconstruct a limb with the pieces that are left or lose it altogether. It’s become an increasingly difficult choice.
Studies so far have shown mixed results. Amputees tend to get through rehab more quickly. Limb salvage patients reportedly experience a higher quality of life, but another study shows the opposite. Another said there is no clear difference in the quality of life between the two choices.
One study found that if a patient and doctor agree to amputate, the sooner the operation is done (within 90 days), the better the outcome for the patient will be.
It’s a difficult choice, with no clear answer. Much depends on the severity of the injury. For example, above-knee amputees had a harder time adjusting to their prosthetic than below-knee amputees. Someone who loses a hand will experience a significant lifestyle change compared to someone who loses a foot.
The good news is prosthetics and limb reconstruction surgery has advanced a great deal over the past two decades. Talk to your doctor about your options and make sure you understand the pros and cons of either choice so you can do what’s best for you in the long run.
How to Treat a Severed Limb or Digit
If someone’s body part has been partially or completely severed, emergency first aid must be administered immediately. Here’s how to handle the situation calmly and efficiently.
Dealing with the Scene of the Injury
- If there are people nearby, get their attention. Have any machines being used turned off.
- Don’t remove any clothing or jewelry near the wound.
- Call 911 for an ambulance or ask someone to drive you to the emergency room.
- If the digit or limb was completely cut off, look for it or have someone else find it.
Taking Care of the Injury
- Gently rinse the wound with water or sterile saline
- Cover the wound with sterile gauze or bandage
- Elevate the injured body part above the heart to reduce bleeding and swelling
- Put slight pressure on the wound to help stop the bleeding
- Don’t squeeze or tightly bandage the area as this could cut off the blood flow completely
Taking Care of the Severed Body Part
- Gently rinse off the amputated toe, finger or another body part with water or sterile saline
- Cover it in damp gauze or sanitized wrap
- Place it in a clean, waterproof bag
- Place that bag in another larger plastic bag
- Place the bundle on ice (or in cold water if there is no ice)
- If there is more than one body part severed, put each into its own individual bag to prevent infection and further damage
- Don’t place the body part directly on ice
What to Do if a Person Goes Into Shock
It is possible the injured person may go into shock (this happens due to a drop in blood pressure). The most important thing to remember is to keep them warm and get them to the hospital as quickly as possible. Signs they have gone into shock include:
- anxiety or agitation
- cool or clammy skin
- dizziness or fainting
- fast breathing or heart rate
- pale skin
Can a Severed Limb or Digit Be Reattached?
In some cases, yes. Fingers and toes are easier to reattach; doctors have been doing it for years. In one rare case, a woman received a double-hand transplant.
Whether reattaching a severed or partially severed body part or transplanting a new one, the surgeries involve similar procedures. First, the patient is given anesthesia so they do not feel pain. The surgeon may need to remove damaged tissue to prevent infection (i.e., debridement).
Then the bones are rejoined by screws and plates or wires — the exposed ends may be trimmed if there is damage. Microsurgery is performed by sewing the arteries, tendons, nerves, and skin back together.
The hardest part of a digit or limb being severed and then reattached is getting the nervous system to cooperate. Not only do the nerves need encouragement to reattach, but the brain needs to be reminded how to move a limb or digit.
Nerve damage is common after a severe injury, many patients experiencing weakness, numbness, tingling, stiffness, and pain. Other problems that may soon go away or stay long term include pain, blood clots, cold sensitivity, arthritis, muscle atrophy, scarring, and drooping.
Hours of therapy will be necessary to stretch, bend, reach, and massage the nervous system to be fully functional once more. If a transplant is done, the patient will require medication for their entire lives so the body does not reject the foreign tissue.
How an Amputation Procedure Works
An amputation typically requires a patient to stay in a hospital for five to 14 days or more. The duration depends on the complexity of the procedure and the total severity of the patient’s injuries.
Amputation can be performed while the patient is under general anesthesia (unconscious) or spinal anesthesia, which numbs the body from the waist down. A surgeon will do everything they can to preserve as much healthy tissue as possible.
Before the procedure, a doctor will examine the best place to cut by using the following methods:
- Checking the skin for reddish areas
- Checking the skin near the surgical site to see if it is still sensitive to touch
- Comparing skin temperatures between the affected limb and a healthy limb
- Checking for a pulse near the surgical site
Once the cut site has been determined, the surgeon will remove any diseased tissue and crushed bone, smooth uneven surface areas of bone, seal off blood vessels and nerves, and cut and shape muscles so that the stump will be able to have an artificial limb attached to it (if applicable).
The surgeon may decide to close the wound right away (closed amputation) or leave the area open for a few days in case they need to remove additional tissue. Sterile bandages and drainage tubes may be placed over the stump afterward. A splint or traction may be needed to hold the affected area in place.
Life After Amputation
Amputations require significant surgery and medical assistance. The experience, even if it is not caused by a violent accident, can still be tough on an individual emotionally and physically. It is important an amputee is supported during their transition into a new way of life.
One of the most important parts of the recovery process after surgery is rehabilitation. Rehabilitation includes wound healing, building back strength, preparing the limb for a prosthetic (pre-prosthetic training), learning how to walk or operate the prosthetic with or without assistance, and learning how to care for the affected limb and its prosthetic.
After a person is fitted with a prosthetic, treatment focuses on physical and occupational therapy. The purpose is to help them regain optimal mobility and function, increase endurance, and maximize comfort and confidence. Practice with an artificial limb may begin as early as 10 to 14 days after surgery.
In addition to personalized one-on-one training, group therapy may be used to help provide mutual support and inspiration. Vocational therapy is also available to develop the skills a person needs to get back to work or favorite hobbies.
Ideally, the wound should heal in four to eight weeks. Physical and emotional adjustment, however, will likely be a much longer process.
One of the most common complications after an amputation is the phenomenon known as phantom limbs, where a person can still feel their missing body part even though it is no longer there. The limbs may ache, itch, or feel as if they are moving or vibrating. Scientists believe this is likely due to the neural map the brain creates for the body; neurons dedicated to the specific body part are still active, causing the continued sensations.
Phantom limb pain can be brief or long-lasting and severe. If you experience these symptoms, tell your doctor as soon as possible to get it treated. The pain may feel like burning, shooting, prickly, twisting, crushing, or jolting.
Grief is also a common reaction to losing a limb. This is perfectly understandable as a person has lost a literal part of themselves and their quality of life may change as a result. Medication and counseling may be recommended to help a person cope with the trauma and changes they have had to undergo.
Other complications may include infections, swelling, blood clots, additional amputation surgeries, and heart problems.
Filing a Personal Injury Claim or Obtaining a Workers’ Compensation Claim for an Amputation or Crush Injury
Amputation, especially if the result of severe trauma or crush injury, can feel devastating. You may be worried about exorbitant medical and rehab costs. Limb salvage can cost even more, requiring a dozen or more surgeries, some long after the personal injury event happened.
Crush injuries, limb salvage, and amputation frequently lead to lifelong disabilities and complications. Anxiety, depression, PTSD, substance abuse issues, and mood disorders as a result of the severe injury may also reduce the quality of life.
Our attorneys can help you obtain coverage for your medical bills, including those related to past, present, and future complications; psychological trauma; permanent disability; and more. Even if the accident was partially your fault, we can still help you receive full compensation for your pain and suffering.
Our Georgia law firm takes care of you and your family. We act as a protective buffer between you and the insurance company, zealously fighting for your physical and financial recovery.
Schedule a free consultation with one of our Atlanta-based personal injury lawyers today. We offer several convenient meeting locations throughout the metro area.