What is a stump?

 
multiple amputee This man lost his arms and legs after suffering meningitis

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.

People born without all or part of an arm or leg, are said instead to have a limb difference.

How is a stump created?

How common are amputations?

  • Approximately 5-6,000 major limb amputations carried out in the UK every year
  • Most common reason for leg amputation is a loss of blood supply to affected limb (critical ischaemia)
  • Trauma is most common reason for upper limb amputation
  • Diabetes sufferers are 15 times more likely to need an amputation than general population, because high blood glucose levels can damage blood vessels, leading to restriction in blood supply
  • More than half of all amputations performed in people aged 70 or over; men twice as likely to need an amputation as women

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.

Cerrie Burnell CBeebies presenter Cerrie Burnell was born with a limb difference
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.

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"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.

Diane's top stump care tips are to "keep it really clean and take your prosthesis off as much as possible".

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