At the Lower Extremity Clinic at the University of Michigan Health, we offer complete, compassionate care, taking you from the amputation process to getting you back to daily living by listening to your needs, providing you a thorough education and utilizing the most current therapy and prostheses available. In addition to amputation, our Lower Extremity Clinic cares for and treats patients with conditions such as leg and foot wounds, leg and foot deformities, peripheral vascular disease, foot pain and diabetic foot care. We coordinate care among our physiatrists (a physician who specializes in physical medicine and rehabilitation), prosthetists (certified to design, fabricate and fit prostheses) and therapists in order to fully address mobility, pain and function issues.

Levels of Lower Extremity Amputations

Levels of Lower Extremity Amputations include:

• Foot, including toes or partial foot
• At the ankle (ankle disarticulation)
• Below the knee (transtibial)
• At the knee (knee disarticulation)
• Above the knee (transfemoral)
• At the hip (hip disarticulation)

In the U.S., more than 60% of all lower-leg amputations that are not related to an accident are performed because of diabetes.

At the Upper Extremity Clinic at University of Michigan Health, we offer complete, compassionate care, taking you from the amputation process to getting you back to daily living by listening to your needs, providing you a thorough education and utilizing the most current therapy and prostheses available.

In addition to amputation, our Upper Extremity Clinic cares for and treats patients with conditions such as brachial plexus (nerves that control shoulder, arm and hand movement) injuries. We coordinate care among our physiatrists (a physician who specializes in physical medicine and rehabilitation), prosthetists (certified to design, fabricate and fit prostheses) and therapists in order to fully address mobility, pain and function issues.

Levels of Upper Extremity Amputations

Levels of upper extremity amputations include:

• Fingers or partial hand (transcarpal)
• At the wrist (wrist disarticulation)
• Below the elbow (transradial)
• At the elbow (elbow disarticulation)
• Above the elbow (transhumeral)
• At the shoulder (shoulder disarticulation)
• Above the shoulder (forequarter)

Before you can get fitted for a prosthesis (a replacement for a lost limb or a limb deficiency), you must first go through physical therapy to gain strength and range of motion, and occupational therapy to learn how to adapt to daily living tasks without a prosthesis. This also gives your wound time to heal, and for the swelling to go down so your prosthesis fits properly. Wearing a shrinker sock (a tight, elastic covering worn over the limb) is key to reducing swelling and molding the limb for a more comfortably fitting prosthesis. An at-home exercise program will be created to prevent contracture (a permanent shortening of a joint due to inactivity). 

Healthy trauma patients are fitted for customized, lower extremity prostheses within 4 to 6 weeks, while the diabetic population takes longer for healing, typically 6-8 weeks.

Most patients are fitted for customized, upper extremity prostheses within 30 days. We do this quickly so you don’t develop a preference for one-handedness. It takes time and patience to learn how to perform daily tasks with a prosthesis, so a quicker transition will make you more likely to use your prosthesis.

Your First Prosthesis

Your first prosthesis is called a provisional prosthesis. Your limb will still be healing and changing at this point and you won’t get your definitive (final) prosthesis until the limb is stabilized. Think of it as getting used to a one-speed bike before taking off on a 27-speed mountain bike. You may need physical therapy to learn how to use your prosthesis. There are a variety of prosthesis options, which your team will discuss with you, based on your age, lifestyle, needs and insurance.

To make an appointment with our amputee clinic or post-polio physician specialists, please call the Orthotics & Prosthetics Call Center at (734) 973-2400.