11 Common Causes of Amputation in the United States

Amputation involves the removal of a limb or part of a limb when it can't be saved. Accidents are a common cause, and one that people can (and should) work to prevent and prepare to respond to ahead of time to minimize the damage. Amputations in the United States also frequently result from long-term conditions like diabetes and vascular disease.

Understanding the leading causes of amputation (ordered here by theme rather than frequency) shows where prevention and early intervention have the greatest impact. Recognizing risks early and responding quickly often determines whether a limb, or a life, is saved.

1. Hemorrhage-Related Limb Loss

Uncontrolled bleeding is one of the fastest ways to cause the loss of a limb or someone's life. Severe blood loss cuts off oxygen to tissues, leading to irreversible damage if not managed immediately. When blood flow can't be restored, amputation is often the only option to prevent the patient's death.

Tourniquets, pressure dressings, and hemostatic gauze are life-saving tools that stop bleeding, preserve tissue, and improve survival rates. Contrary to the myth that tourniquets lead to amputations, research shows that properly applied tourniquets do not increase the risk of amputation. Delays in bleeding control, not the device itself, are what most often doom the affected limb.

Having the right tools, like SWAT-T or CAT tourniquets, is only part of the solution. Accessible bleeding control kits and trained bystanders who are prepared for emergencies greatly increase the chances of saving a limb and a life. Quick action, followed by advanced trauma care, will determine the outcome for the patient.

2. Traumatic Amputations

Traumatic amputations happen when an accident fully severs a limb or severely damages an extremity, necessitating its removal. In some cases, the fully or partially amputated limb is able to be reattached if emergency care is rapid and effective, but often the injury results in permanent limb loss.Traumatic incidents are the second most common cause of amputations.

Uncontrolled bleeding during an accidental amputation emergency quickly leads to shock and death if not managed immediately. Immediate bleeding control and proper care of the residual limb often determine whether the patient's limb or life is saved.

Common causes of accidental amputations in the US include:

• Motor vehicle accidents
• Industrial and agricultural accidents
• Construction site accidents
• Machinery incidents in the workplace (Machinery caused 58% of occupational amputations in 2018.)
• Firearms and explosions
• Severe burns and electrocution

Preventing accidental amputations requires awareness, proper safety equipment, and immediate response when a traumatic accident occurs. Quick action by bystanders and trained responders drastically improves the chances of saving a limb and a life.

3. Peripheral Vascular Disease (PVD)

Peripheral artery disease, a form of PVD, is a leading cause of amputation in the US. It accounts for a large share of lower limb amputations every year. PAD occurs when the arteries that supply blood to the limbs become narrowed or blocked due to atherosclerosis, reducing blood flow and depriving tissues of oxygen.

In advanced stages, PAD often progresses to critical limb ischemia, when the tissue becomes oxygen-starved and necrotic. At that point, amputation is frequently the only way to prevent life-threatening complications.

Risk factors for peripheral arterial disease include smoking, diabetes, high blood pressure, and high cholesterol. Finding PAD early and treating it aggressively slows disease progression. Lifestyle changes, such as quitting smoking, controlling diabetes, and regular exercise, have been shown to dramatically reduce the risk of PAD-related amputations.

4. Diabetes Mellitus

Diabetes mellitus, especially when poorly controlled, is one of the leading causes of limb amputation in the US. High blood sugar damages blood vessels and nerves, causing poor circulation and reduced sensation in the lower limbs. This makes it easy for injuries or a foot ulcer to go unnoticed and be difficult to heal.

Ulcers or wounds that fail to close often become infected, spread to deeper soft tissue, and progress to gangrene. At that stage, surgical removal of the affected limb is often the only life-saving measure. Each year, more than 160,000 diabetic patients in the US undergo amputations (equalling one amputation every 3 minutes and 30 seconds!).

Consistent glycemic control, daily foot inspections, and timely treatment of even minor wounds are the best ways to lower the risk of amputation. With the right preventive care, many diabetes-related amputations are avoided.

5. Neuropathy

Neuropathy (nerve damage) often results from diabetes or other systemic conditions and causes loss of sensation in the limbs. This numbness lets injuries go unnoticed, leading to infection and tissue death that ultimately requires amputation.

Regular checks of the feet for cuts, blisters, or irritation, combined with properly fitted footwear, reduce the risk of complications from nerve damage. Education on foot care and injury prevention helps individuals with neuropathy protect their limbs and prevent loss.

6. Severe Infections

Severe infections destroy tissue quickly, threatening both limb and life. Even small wounds spiral into dangerous infections if not treated early. In advanced cases, amputation is sometimes the only way to stop the spread.

Common infections linked to amputations include:

• Diabetic Foot Infections: Wounds that don’t heal and become deeply infected
• Necrotizing Fasciitis: A fast-spreading “flesh-eating” infection that kills soft tissue
• Gangrene: Dead tissue caused by infection and poor circulation
• Osteomyelitis: A bone infection that is hard to cure once advanced

Early recognition and treatment with antibiotics and debriding surgery are critical to prevent these infections from progressing to amputation.

7. Sepsis

Sepsis is a severe body-wide reaction to infection. While many cases are treated successfully, about 1% of patients still require limb or digit amputation—roughly 17,000 amputees per year. Prompt recognition and treatment are critical to preventing amputation and saving lives.

8. Cancer

Certain cancers, especially those affecting bones and soft tissues, often lead to amputations when the tumor can't be surgically removed. Amputation is considered when removing the limb gives the best chance to eliminate all the cancerous tissue and improve the patient's survival.

As a last resort, amputation serves as a life-saving measure when combined with chemotherapy or radiation. Early detection and careful surgical planning are key to determining whether the limb is saved or must be removed.

9. Blood Clots

Blood clots, also called deep vein thrombosis (DVT), block blood flow in the veins and threaten tissue health. If left untreated, they lead to severe complications that require amputation surgery.

Anticoagulants and compression therapy help manage clots and prevent progression. Detecting blood clots early and starting treatment quickly is critical to preserving the limb.

10. Frostbite

Frostbite occurs when skin and underlying tissues freeze due to prolonged cold exposure. Severe cases destroy tissue and require amputation. Early signs include numbness, tingling, pain, throbbing, and discoloration of the affected area.

Immediate rewarming and medical treatment are critical to limit tissue damage. When tissue death is extensive, surgery is necessary to remove the affected areas and prevent further complications.

11. Congenital Conditions

Congenital limb deficiencies occur when a baby is born with part or all of a limb missing or underdeveloped. The CDC reports that about 1 in every 2,100 babies in the U.S. is born with a limb reduction defect. In some cases, amputation of the underdeveloped limb is necessary to improve function or prepare for prosthetic use.

Early intervention with physical therapy and prosthetic training supports mobility and independence. Advances in prosthetics have greatly improved outcomes and quality of life for those with congenital limb loss.

Protecting Limbs, Saving Lives

Preventing amputation begins with awareness and early intervention. Proper management of chronic conditions, such as diabetes and vascular disease, lowers the risk of limb loss. Monitoring for early warning signs and addressing complications quickly gives patients the best chance to preserve their limbs.

Traumatic and accidental amputations show the critical importance of immediate bleeding control and emergency care. Severe infections, sepsis, and cancer demonstrate how acute medical conditions will progress to limb loss without timely treatment. Understanding these causes empowers individuals and caregivers to take steps that protect limbs and overall health.