The Paralympics brought prosthetics
such as running blades into the limelight. But what about the body parts that
keep them attached?
What is a stump?
After an amputation, the bit that's
left beyond a healthy joint is called a residual limb, or more commonly, a
stump.
How is a stump created?
To amputate, surgeons cut
through skin, muscle, blood vessels, nerves and bone. The exposed bone then
gets filed smooth, with rounded edges. Nerves are cut slightly higher than the
main amputation area and retracted up into the muscle, to prevent potentially
painful bundles of nerve cells from forming close to the stump's surface.
The remaining muscle gets
reattached to bone, providing protective padding and helping to shape the
stump. Skin is sewn together in such a way that once healed, the scar won't rub
against an artificial limb.
Do
stumps change over time?
Stumps shrink so much during their
first months, that the sockets of prosthetic limbs - which are measured before
surgery - become too big and need replacing. In the meantime, thick stump socks
are worn to keep the prosthesis in place.
Once stable, stumps are checked at
least once a year for potential problems. Growing children may need surgery to
trim the bone. Heather Mills had a revision amputation in 2003, after muscle
detached itself, causing skin and bone to rub painfully against each other as
she walked.
Do
stumps need looking after?
Skin wasn't designed to spend hours
each day inside a plastic socket. Diane Mulligan, who lost her leg above the
knee in a motorbike accident eight years ago, likens wearing a false leg to
wearing the same pair of 80s jelly shoes, every single day.
"My skin rubs against
the plastic and breaks down very easily," she says. "I get sores and
cracked skin as a result."
She uses an anti-chafing cream
that works "like Teflon on a non-stick saucepan".
Diane says she tried Botox
to reduce sweating because her stump smelled so badly. When ingrowing hairs on
her stump became infected, she couldn't wear her prosthesis for weeks. And like
many amputees, she gets pain in the place where her missing limb was. This is
known as phantom limb pain.
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