Handicap International, Brussels, Belgium.
Int Orthop. 2012 Oct;36(10):2003-5. doi: 10.1007/s00264-012-1553-2. Epub 2012 May 4.
Losing a limb (or a part of a limb) usually leads to loss of functionality and subsequent disability. This paper aims at pointing out the importance of comprehensive and multidisciplinary care that includes early, direct or indirect, involvement of rehabilitation service providers even in an emergency context.
We underline the links between amputation and disability as well as the milestones and main purposes of the rehabilitation process following amputation. We then emphasise the influence that the level of amputation has on functional outcomes.
In order for functional outcomes to balance purely medical factors when identifying the best site for amputation in emergency settings where preoperative involvement of a rehabilitation professional is difficult due to limited resources, we enunciate five general rules to be used as guidelines by the medical team in the absence of a rehabilitation service provider. These five rules, remaining general enough to apply to most contexts and patients, still need to be balanced against contextual and personal factors that can only be identified at the time of the amputation.
The main expectations of people who undergo surgery are, usually, to remain actors in the society and regain functional abilities. Therefore, surgical outcomes are closely related to functional outcomes. In order for the functional and personal factors to be taken into account, we recommend, even in an emergency context, preoperative involvement of rehabilitation care providers.
失去肢体（或肢体的一部分）通常会导致功能丧失和随后的残疾。本文旨在指出包括康复服务提供者在内的全面和多学科护理的重要性，即使在紧急情况下，也需要尽早、直接或间接的参与。
我们强调了截肢与残疾之间的联系，以及截肢后康复过程的里程碑和主要目的。然后，我们强调了截肢水平对功能结果的影响。
为了在紧急情况下确定截肢的最佳部位，在由于资源有限而难以在术前让康复专业人员参与的情况下，功能结果需要平衡纯粹的医学因素。因此，我们制定了五项一般规则，供医疗团队在没有康复服务提供者的情况下作为指南使用。这五条规则足够一般，可以适用于大多数情况和患者，但仍需要与上下文和个人因素相平衡，这些因素只能在截肢时确定。
接受手术的人的主要期望通常是在社会中保持活跃并恢复功能能力。因此，手术结果与功能结果密切相关。为了考虑功能和个人因素，我们建议即使在紧急情况下，也应在术前让康复护理提供者参与。
