Toronto Amputation Lawyer - Injury Compensation
Our personal injury lawyers in Toronto can help you assert your legal rights and get the compensation you deserve following a limb amputation. If you, or someone you know, have suffered an accidental traumatic amputation caused by the negligence of another person and you would like to know if it is possible to claim compensation, just call the helpline or complete the contact form or email our Toronto offices and a Toronto amputation lawyer will telephone you with legal advice at no cost.
Limb amputations are not a common phenomenon in Ontario. Traumatic limb amputations happen as a result of car accidents or in rare recreational injuries, such as logging or traumatic falls. Amputation usually takes place because the circulation of the limb is impaired usually due to trauma in an accident and the tissue is crushed beyond repair. Doctors attempt to repair as much of the damaged leg or arm as possible but that part which cannot be saved is amputated.
More amputations are done for reasons which are not traumatic than for traumatic injuries. In these situations, there is usually no one negligent and the cause of the amputation is blockage of the arteries of the legs in diseases like peripheral vascular disease, type II diabetes and hyper-cholesterolemia. Diabetes makes up about 30-40 percent of all amputations performed in Ontario.
Amputations as a result of a car accident in Toronto are rare. Limb amputations in general are not common. They can occur as a result of a motorcycle accident, car accident, recreational injury or occupational injury. A limb amputation results from one of two things. There can be a crush injury to the limb so that the circulation and body parts are destroyed, leaving the doctor no other choice but to amputate the leg. In addition, a traumatic amputation can occur where the limb is cut off in situ, in an accident at work or rarely in a car accident.
Amputations are listed according to their level. There can be a Simes amputation in which just the forefoot is amputated. There can also be a below the knee amputation. These are easier amputations than above the knee amputations because when walking the knee is used as part of the ambulation. Above the knee amputations occur between the hip and the knee. Doctors can make orthotic devices for all kinds of amputations but above the knee amputation prostheses are more complex and difficult to get right because it is hard to duplicate the way the knee works.
In arm amputations, there can be small amputations of one or more finger. These usually do not cause marked difficulty in how a person functions afterwards. Below the elbow amputations may or may not require prosthesis. The patient may choose to function with a partial limb or may decide to have a prosthesis attached. The same is true of above the elbow amputations, in which the forearm and elbow are lost. Prostheses of this type are difficult because it is difficult to mimic the operability of the elbow.
Even if you have an amputation and are lucky enough to have a reattachment, you will still have some degree of disability to the affected limb. There can be a loss of sensation or a loss of some aspect of the function of the extremity that will still lead to a disability.
Mangled Extremity Score
In situations where it is unclear whether or not to amputate the limb, doctors perform a Mangled Extremity Score. This is a scoring system that includes the patient’s age, body temperature, general health, degree of paralysis, amount of circulation, degree of numbness and the health of the tissue. Patients get a score between 2 and 14. Patients with scores of 6 or less stand a better chance of having a successful amputation, especially if less than six hours have transpired between the accident and the time of surgery.
Major amputations usually require prosthesis once the wound has healed. Sometimes a minor amputation is carried out with a major amputation done at a later date if the first minor amputation does not heal properly. Major amputations usually require prosthesis. The blood supply to the amputated area determines whether or not the amputation is going to succeed. If there is infection after the surgery, the wound will not heal. A small the amputation has a greater chance of healing and is more likely to allow functionality without the necessity for prosthesis.
There are some amputees that have special prosthetics devised for them that allow them to participate in competitive running. They often don’t look like normal feet but they are kinetic wonders that enhance the ability to run and function. There is controversy as to whether amputees with prosthetic feet containing spring steel should be allowed to compete against able bodied athletes who may be disadvantaged by the hi-tech metallic structure used by the disabled athlete.
Physicians Overview of Limb Amputation
There are many reasons why a person would need to have a limb amputation in Toronto. Certainly a bone tumor or other severe disease in the limb such as a loss of circulation to the limb can result in the need to have the limb amputated. In the latter case, the individual gets a blackened extremity from severe peripheral vascular disease or diabetes and part of the limb can fall off or is removed surgically.
A person might also have a trauma to the limb that results in a mangled limb or in a limb that is amputated as a result of the trauma. Severe car accidents can mangle a limb and injuries sustained in combat, such as a bombing injury, can result in immediate loss of the limb. This is the life’s blood of the combat trauma surgeon who can attempt to save an injured leg or must make the choice to amputate the limb to save the soldier’s life.
An infection in the limb that does not improve with antibiotics or surgery might need to be treated with a surgical infection. Another cause of amputation is a neuroma or nerve tumor of the extremity that cannot be removed by any other means.
Frostbite can lead to amputation, especially if the blood has crystallized, thus permanently damaging the peripheral aspects of the extremities. Frostbite most commonly affects the toes, the foot, the fingers and the hand. Frostbite usually happens during a prolonged time of being in freezing temperatures.
An amputation can involve much of an arm or leg, a foot, hand, toe or finger. In cases of diabetes, it is often the toes that become gangrenous first, followed by the foot and then sometimes the fingers. The same is true of peripheral vascular disease. It is the most distal of all the extremities that suffers first from the effects of the disease.
About 1.8 million US citizens are living with an amputation. The most common type of amputations are the above the knee amputation and the below the knee amputation.
The Process of an Amputation
When the patient requires an amputation, they need to expect about 5 days in the hospital and up to 14 days if they have other serious illnesses or complications. The amputation procedure itself is a quick procedure involving removal of damaged tissue so that the remaining tissue is healthy enough to heal on its own.
Amputations are done under general or spinal anesthesia, depending on the health of the patient and their ability to tolerate general anesthesia. Spinal anesthesia involves inserting a needle around the spinal cord in the lumbar area, affecting anesthesia from the waist down. This works well for leg but, of course, not for arm anesthesia.
The trick of doing an amputation that takes off enough tissue but not too much tissue involves several processes. First, the surgeon looks for the presence of a pulse in the groin, the knee and in the ankle. If a pulse is felt at the level of the knee but is lost by the time the surgeon reaches the elbow, then the leg may be taken off at or slightly below the level of the knee.
The surgeon can also look for skin temperature variations along the limb. If the arm, for example, is warm to the elbow but cold below the elbow, the cold part and a portion of the warm part needs to be removed. Similarly, the surgeon can look for the degree of redness or purple coloration of the skin of the extremity. If the skin Is dusky and red, it is probably not healthy enough to survive an amputation and must be taken off.
The surgeon can look for areas of sensitivity versus insensitivity of the affected limb. The portion of the extremity that is not sensitive to a pinprick or to touch may not be viable tissue and might need to be removed in an amputation procedure.
The surgeon will, in the course of an amputation procedure, remove any diseased tissue and crushed areas of bone. The bone that is left is smoothed so that it is not uneven. Any bleeding blood vessels are sealed off and muscles are trimmed and reconnected so that the stump will be able to have an artificial limb placed on it for future ambulation.
If the area is severely damaged or if there is active infection, the surgeon may elect to keep the wound open so that it heals secondarily on its own or so that another surgery can be done to close the skin flaps around the end of the stump. Sometimes the site is open only for a few days so that if some is destined to die, it can be removed in a later procedure. A sterile dressing and stocking are placed over the stump and drainage tubes are applied for a few days. Traction or a splint might be applied to enhance the healing and comfort following the surgical procedure.
Recovery from a Limb Amputation
After an amputation, the nursing staff will change the dressings around and on the wound until the patient himself learns to change them. Diseases like diabetes are managed and pain medication is used to control surgical pain. Phantom pain is pain that the patient feels which has him to believing that the limb is still present. It is extremely difficult to treat this kind of pain and sometimes the patient must live with it for the rest of his days.
Physical therapy is started, usually beginning with easy, stretching exercises. The patient may begin to practice using the amputated limb within 10 days or more after surgery. The wound itself often heals within 4 to 8 weeks and the patient can begin a rehabilitative period in which the extremity is strengthened and thoughts of a prosthetic limb can be entertained.
Overall, the rehabilitation involves exercises to strengthen the joints and the muscle, activities to learn about how to become independent and do things independent of the extremity, use of an artificial limb and any assistive devices that might be necessary and getting emotional support and counselling to help with the grief and sadness of losing a limb, especially if it was lost in a traumatic incident.