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Amputation
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==Prognosis== The individual may experience psychological trauma and emotional discomfort. The stump will remain an area of reduced mechanical stability. Limb loss can present significant or even drastic practical limitations.<ref name="Amputation">{{Cite web |date=2023-03-15 |title=Amputation |url=https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/amputation |access-date=2023-10-31 |website=www.hopkinsmedicine.org |language=en}}</ref> A large proportion of amputees (from 50 to 80% to 80-100%, according to different studies) experience the phenomenon of [[phantom limb]]s;<ref>{{cite journal|date=January 2005 |title=The Science of Things | first = Heidi | last = Schultz | name-list-style = vanc |journal=National Geographic Magazine |url=http://magma.nationalgeographic.com/ngm/0501/resources_who.html |url-status=dead |archive-url=https://web.archive.org/web/20080906143209/http://magma.nationalgeographic.com/ngm/0501/resources_who.html |archive-date=September 6, 2008 }}</ref><ref name="PhantomReview2007">{{cite journal |last1=Chahine |first1=Lama |last2=Kanazi |first2=Ghassan |date=2007 |title= Phantom limb syndrome: A review |url=https://pdfs.semanticscholar.org/0f8d/2b80b5c20ed0e21076de4b5ac48327ca05d2.pdf |archive-url=https://web.archive.org/web/20190721010514/https://pdfs.semanticscholar.org/0f8d/2b80b5c20ed0e21076de4b5ac48327ca05d2.pdf |url-status=dead |archive-date=2019-07-21 |journal= MEJ Anesth|volume=19 |issue= 2|pages=345β55 |s2cid=16240786 |access-date=July 20, 2019 }}</ref> they feel body parts that are no longer there. These limbs can itch, ache, burn, feel tense, dry or wet, locked in or trapped or they can feel as if they are moving. Some scientists believe it has to do with a kind of neural map that the brain has of the body, which sends information to the rest of the brain about limbs regardless of their existence. Phantom sensations and phantom pain may also occur after the removal of body parts other than the limbs, e.g. after amputation of the breast, extraction of a tooth (phantom tooth pain) or removal of an eye ([[phantom eye syndrome]]). A similar phenomenon is an unexplained sensation in a body part unrelated to the amputated limb. It has been hypothesized that the portion of the brain responsible for processing stimulation from amputated limbs, being deprived of input, expands into the surrounding brain, (''[[Phantoms in the Brain]]'': [[V.S. Ramachandran]] and [[Sandra Blakeslee]]) such that an individual who has had an arm amputated will experience unexplained pressure or movement on his face or head.<ref>{{Cite journal |last1=MacIver |first1=K. |last2=Lloyd |first2=D. M. |last3=Kelly |first3=S. |last4=Roberts |first4=N. |last5=Nurmikko |first5=T. |date=August 2008 |title=Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery |journal=Brain |volume=131 |issue=8 |pages=2181β2191 |doi=10.1093/brain/awn124 |issn=0006-8950 |pmid=18567624|pmc=2494616 }}</ref> In many cases, the phantom limb aids in adaptation to a prosthesis, as it permits the person to experience [[proprioception]] of the prosthetic limb. To support improved resistance or usability, comfort or healing, some types of [[stump sock]]s may be worn instead of or as part of wearing a prosthesis.<ref name="Amputation"/> Another side effect can be [[heterotopic ossification]], especially when a bone injury is combined with a head injury. The brain signals the bone to grow instead of scar tissue to form, and nodules and other growth can interfere with prosthetics and sometimes require further operations. This type of injury has been especially common among soldiers wounded by [[improvised explosive device]]s in the [[Iraq War]].<ref>{{cite news |url=http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/03/26/MNSOLDIERS26.DTL |title=War without end / Damaged soldiers start their agonizing recoveries |first=Joan |last=Ryan |name-list-style=vanc |date=March 25, 2006 |work=The San Francisco Chronicle |archive-url=https://web.archive.org/web/20110208093622/http://www.sfgate.com/cgi-bin/article.cgi?f=%2Fc%2Fa%2F2006%2F03%2F26%2FMNSOLDIERS26.DTL |archive-date=February 8, 2011 |url-status=live |access-date=June 4, 2017 }}</ref> Due to technological advances in prosthetics, many amputees live active lives with little restriction. Organizations such as the [[Challenged Athletes Foundation]] have been developed to give amputees the opportunity to be involved in athletics and [[adaptive sports]] such as [[Amputee football|amputee soccer]].<ref>{{Cite web |last=Hoock |first=Maja |date=September 2021 |title=Innovative prostheses positively change the Paralympics |url=https://www.wipo.int/wipo_magazine/en/2021/03/article_0007.html |access-date=October 30, 2023 |website=WIPO}}</ref> Nearly half of the individuals who have an amputation due to vascular disease will die within 5 years, usually secondary to the extensive co-morbidities rather than due to direct consequences of an amputation. This is higher than the five year mortality rates for breast cancer, colon cancer, and prostate cancer.<ref>{{cite journal | vauthors = Robbins JM, Strauss G, Aron D, Long J, Kuba J, Kaplan Y | s2cid = 38232703 | title = Mortality rates and diabetic foot ulcers: is it time to communicate mortality risk to patients with diabetic foot ulceration? | journal = Journal of the American Podiatric Medical Association | volume = 98 | issue = 6 | pages = 489β93 | date = November 2008 | pmid = 19017860 | doi = 10.7547/0980489 }}</ref> Of persons with diabetes who have a lower extremity amputation, up to 55% will require amputation of the second leg within two to three years.<ref>{{cite book| vauthors = Savage PE |chapter=The diabetic foot|date=1983|pages=69β73|publisher=Springer Netherlands|isbn=9789401166508|doi=10.1007/978-94-011-6648-5_12|title=Problems in Peripheral Vascular Disease}}</ref>
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