Amputation and Prosthetic Optimization in Delhi
Amputation and Prosthetic Optimization in Delhi is goal‑oriented surgery designed for comfortable prosthetic use, reliable wound healing, and confident mobility. When limb salvage risks outweigh benefits, we plan the right level, create a stable, well‑padded residual limb, manage nerves to reduce neuroma and phantom pain (TMR/RPNI as indicated), and coordinate rapid prosthetic fitting. We do not provide in‑house physiotherapy services; we share written protocols and coordinate with your physiotherapist for phased, criteria‑based gait training.
Level selection • Residual limb design • TMR/RPNI • Socket + components • Return to mobility
About Amputation and Prosthetic Optimization in Delhi
Amputation and Prosthetic Optimization in Delhi is a deliberate reconstructive pathway to restore function and quality of life when a limb is non‑salvageable or unsafe. Our focus is threefold: choose the right level, build a strong and comfortable residual limb, and eliminate obstacles to prosthetic success (skin issues, neuromas, contractures, poor socket tolerance). Every detail—from scar placement to muscle balancing—affects whether you walk confidently or struggle with the prosthesis.
We work as a team. Vascular surgery assesses perfusion when circulation is uncertain. Infectious disease guides antibiotics if infection is present. Endocrinology supports glucose control in diabetes. Certified prosthetists help plan the socket and components early so you’re ready for a test socket as the wound matures. As Orthopedic Surgeons, we lead level selection, bony alignment, soft‑tissue coverage, and nerve strategies (TMR/RPNI) that determine comfort and durability.
Who Benefits & Decision‑Making
Common indications
Severe trauma, non‑reconstructable infection or osteomyelitis, critical ischemia not amenable to revascularization, near‑nonfunctional limb after repeated surgeries, tumors requiring clear margins, and painful deformity or chronic ulceration that prevents safe mobility.
Shared planning
We discuss functional goals (household ambulation, community walking, work demands), home setup (stairs, railings), caregiver support, and comorbidities to select the level that maximizes independence and reduces complications.
Risk reduction
Glycemic control, nutrition optimization, smoking cessation, infection control, and vascular assessment improve healing and long‑term prosthetic tolerance.
The aim of Amputation and Prosthetic Optimization in Delhi is safe, timely rehabilitation—fewer surgeries, faster wound healing, and a prosthesis you actually enjoy using.
Level Selection & Pre‑Op Planning
- Partial foot: Toe/ray or transmetatarsal amputation (TMA) preserves length and lever arm; often combined with tendon balancing and rocker‑sole footwear or an AFO‑based prosthesis to prevent forefoot overload and equinus.
- Syme (ankle disarticulation): End‑bearing option with bulbous contour; can work well in selected patients, especially when knee function is excellent.
- Transtibial (below‑knee): The most functional level for many; preserves knee power for efficient gait. Length, tibial bevels, fibular handling, and soft‑tissue coverage are planned for socket tolerance.
- Through‑knee (knee disarticulation): Durable end‑bearing with long lever arm; prosthetic knee choices and cosmesis are discussed ahead of time.
- Transfemoral (above‑knee): Chosen when the knee cannot be preserved. Myodesis and adductor balancing improve control; modern microprocessor knees can restore confident community ambulation.
We confirm perfusion (pulses, Doppler, ABI/toe pressures; vascular referral if indicated), plan incisions and flap viability, and involve your prosthetist early for alignment and component planning.
Pain, Nerves (TMR/RPNI) & Phantom Sensations
Nerve management is central to long‑term comfort. Traditional traction neurectomy can still result in painful neuromas. When appropriate, we use Targeted Muscle Reinnervation (TMR) to coapt cut nerves to motor branches, giving axons a meaningful target and reducing neuroma risk. Regenerative Peripheral Nerve Interface (RPNI) uses small free muscle grafts to envelop nerve ends, also lowering neuroma and phantom limb pain in many patients.
Acute TMR/RPNI
Performed at the time of amputation in selected cases to prevent neuroma formation and potentially improve myoelectric signal quality for advanced prostheses.
Revision options
For established neuroma pain, revision surgery with TMR/RPNI can improve socket tolerance and reduce limb‑triggered pain.
Pain strategy
Regional anesthesia, multimodal non‑opioid‑forward analgesia, desensitization, and close glucose control (for diabetics) help minimize phantom pain and speed rehabilitation.
Surgical Technique & Residual Limb Design
Prosthetic success begins in the operating room. We shape bone ends for even load transfer, secure muscles with myodesis/myoplasty for power and stability, and position scars away from weight‑bearing zones. In transtibial cases, tibial bevels, fibular level selection, and, in select patients, a tibio‑fibular bone bridge (Ertl) may improve end‑bearing and socket comfort. For partial foot levels, tendon balancing reduces deforming forces and recurrent ulceration.
- Soft‑tissue envelope: Durable, well‑vascularized coverage; careful flap handling to minimize wound problems.
- Volume shaping: Early edema control and shrinker protocols produce a conical limb that seats well in a socket.
- Wound strategy: Where indicated, negative‑pressure wound therapy (NPWT) protects flaps and accelerates granulation.
The result we aim for: a painless, stable limb that fits a socket predictably and allows long walking days without hotspots.
Prosthetic Interface & Components
We collaborate with certified prosthetists from the start so you transition to a test socket as soon as wounds are stable. The interface (liner + suspension) and foot/knee components are customized to your limb shape, skin condition, weight, activity level, and goals. This coordination is central to Amputation and Prosthetic Optimization in Delhi.
Interface & suspension
Silicone/gel liners, pin‑lock, suction, or elevated vacuum systems. Elevated vacuum can stabilize volume and reduce pistoning in transtibial sockets.
Feet & ankles
From SACH and multi‑axial feet to energy‑storing carbon blades; microprocessor ankles help uneven terrain and slopes for selected users.
Knees (transfemoral)
Polycentric mechanical knees for reliability or microprocessor knees for improved stumble recovery and variable cadence community walking.
Partial‑foot solutions
Toe fillers, rocker‑soled footwear, and AFO‑integrated designs to restore pushoff and prevent forefoot re‑ulceration.
Rehabilitation & Mobility Milestones
We provide a written, phase‑based plan and coordinate with your physiotherapist; we do not provide physiotherapy in‑house. Early goals are wound protection, edema control, knee/hip extension preservation, and safe transfers. As swelling reduces, you’ll move into a shrinker, then a preparatory (temporary) prosthesis, and finally a definitive prosthesis after volume stabilizes. Our criteria‑based pathway is the rehabilitation backbone of Amputation and Prosthetic Optimization in Delhi.
- Week 0–2: Elevation, pain control, desensitization, gentle ROM; protect incisions; wheelchair/walker with safety training.
- Week 3–6: Shrinker or compression wraps; hip/knee extension focus; core and balance work; begin test socket casting when wounds allow.
- Week 6–12: Gait training with preparatory prosthesis; progress to single‑stick; curb and stair practice; adjust socket for volume changes.
- Beyond 12 weeks: Definitive prosthesis fitting; endurance and community ambulation goals; return‑to‑work planning.
We coordinate with your physiotherapist using measurable milestones—comfortable standing tolerance, step symmetry, socket wear time, and safe fall‑recovery strategies.
Daily Limb Care & Prevention
Skin & volume
Daily inspection, liner hygiene, moisture control, and shrinker compliance prevent rashes and blisters. Add or remove socks to match volume changes.
Contracture prevention
Keep the hip and knee straight during rest; avoid prolonged sitting with a flexed knee after transtibial amputation.
Foot care (other limb)
Protect the intact foot—proper footwear, callus care, and glucose control (if diabetic) reduce overload injuries.
Activity & safety
Fall‑prevention strategies, safe transfers, and realistic distance goals. Replace worn liners and feet proactively to maintain performance.
Report persistent redness, drainage, or limb‑triggered pain early—small fixes prevent big setbacks.
Cost & Insurance
Costs vary with indication, level (partial foot vs transtibial vs transfemoral), need for staged debridement or vascular input, use of TMR/RPNI, inpatient stay, and prosthetic component choices (mechanical vs microprocessor). Most insurers cover medically necessary amputation and inpatient care; prosthetic components may have device‑specific limits. We verify benefits and provide a transparent estimate before scheduling your Amputation and Prosthetic Optimization in Delhi.
- Insurance pre‑authorization & benefits check
- Clear estimate of hospital + surgeon + prosthetic costs
- Cashless/financing options where applicable
How to Prepare
Records & tests
Bring prior notes, imaging, vascular studies (ABI/toe pressure), culture reports, and your medication list.
Home setup
Arrange a ground‑floor sleeping option if possible, clear walkways, and add grab bars or rails where needed.
Stop smoking
Nicotine impairs wound healing—complete cessation is strongly recommended.
Physio details
We do not provide physiotherapy services in‑house. Share your physiotherapist’s contact so we can align written protocols.
Prosthetist contact
If you have a preferred prosthetist, bring their details; otherwise we can coordinate with trusted providers.
Where to Consult Dr. Neelabh
BLK Hospital
A-4-6, Pusa Rd, Near Rajendra Place Metro Station, New Delhi-110005
🕓 4:00 PM – 6:00 PM
Timings may vary—please call +91‑9810117204 to confirm.
FAQs
When is amputation the right choice versus limb salvage?
How soon will I walk with a prosthesis?
Can you reduce phantom limb pain?
Do you provide physiotherapy?
Do you offer osseointegration?
Need Amputation and Prosthetic Optimization in Delhi?
Book a consultation. We’ll plan the level, nerve strategy, and prosthetic pathway to get you mobile—safely and confidently.