​What kinds of symptoms do patients experience before receiving treatment?

Unfortunately, injuries from land mines are common in Cambodia. Patients often undergo limb amputations. Following amputation of a leg, a patient is fitted with a prosthetic limb. Surgeons create a stump with enough healthy soft tissue covering the end of the bone to allow pressure to be exerted on it comfortably. Stumps can become painful for a variety of reasons. This pain can compromise the patient's ability to walk. In addition, as scar tissue matures, it can cause distortion of the stump, which may no longer fit into the prosthesis.

​What is the impact on patients’ lives of living with these conditions?

Pain, discomfort, and inability to use a prosthesis make life difficult for patients requiring stump revision surgeries. Painful stumps can make mobility difficult or impossible. Patients lose their independence and ability to work.

What cultural or regional factors affect the treatment of these conditions?

The majority of amputations in Cambodia result from trauma. Patients might sustain landmine injuries or infected open fractures. In contrast, amputations in the United States are usually caused by peripheral vascular disease, associated with a sedentary lifestyle, smoking, and the rising prevalence of obesity and diabetes.

What does the treatment process look like?

First, surgeons examine the stump to determine the cause of the problem. The patient may need surgery to cut away infected tissue, refashion the soft tissue covering the bone, saw off more of the bone, or remove a neuroma that has grown on the cut end of a nerve.

What is the impact of this treatment on the patient’s life?

Walking with a prosthetic limb is much easier than using crutches or a self-propelled wheel chair. Patients can maintain their independence, work, and contribute to their communities. Patients with prosthetic legs tend to experience lower levels of depression because they feel more "normal."

What potential side effects or risks come with this treatment?

This surgery is very safe and very effective.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

The majority of amputees are people who live and work in the countryside. They make up one of the poorest groups in Southeast Asia and cannot afford treatment in private clinics. Children’s Surgical Centre is the only free hospital in Phnom Penh, so it receives the majority of patients with post-operative stump problems.

What are the alternatives to this treatment?

Patients can use crutches or wheelchairs for mobilization. Both of these options are slower, more awkward, expend more energy, and come with their own risks and complications.