Was just reading on pre 20th century amputations and how they strived to be as fast as possible, cutting through bone and all.
Why didn’t they just amputate at the joint, like a butcher cuts pork or beef? That would have been way faster than sawing off though bone.
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It increases the loss of function to do it that way.
If you still have a little bit of leg below your knee, then you can fit a prosthetic on there and move around with it fairly well. But if you take the knee then your entire leg loses the ability to flex altogether and it is much harder to do anything with a prosthetic. Especially the very simple kinds they would have had back there.
Also a lot of muscle attachments for the upper arm and upper leg are on the elbow and knee respectively. So cutting there is going to do damage to the functionality of what limb is still left. Obviously this doesn’t matter when butchering an animal but if you want to keep a human alive it does.
Because the violence of that method would damage more tissue than is necessary. A surgeon has to keep their patient alive after surgery.. a butcher clearly doesn’t.
It is very likely that the first attempts at amputation were similar to the “butcher method” however the outcome would be less successful than performing the operation in stages.
For example, if you chopped off a leg with a sword above the knee in one blow you would be exposing several veins and arteries that would quickly cause rapid blood loss if not dealt with quickly. By making cuts that expose each one individually, they can be tied off until the only thing to deal with is the bone.
TLDR; If you try and amputate too quickly, you create more additional problems to solve than you can handle in a short time frame, leading to lower chances of a successful outcome.
Whilst I’m not a pre 20th century butcher I’d imagine a number of reasons.
1st bleeding
If you want to hack off a limb, you have to cut off the blood supply first, otherwise your patient is going to bleed to death. That has to be done above the point where you’re cutting. If you do it above the joint, you’re cutting blood supply off to the upper bone as well as the lower bone that you’re amputating
2nd infection
When bones get infected, the infection spreads throughout the bone. If you amputate at a joint and infect the upper bone during the operation, then your patient will need a second amputation before long.
3rd prosthetics and mobility
If you amputate at the joint, you lose all function of that joint. If you amputate below, then you retain the ability to bend the stump. You can also add on a wooden peg and retain some function of the missing limb.
You want to **keep** as much of the limb as you can. Surgeons will sit there before an amputation and figure out exactly how many inches of leg they can save, because every inch they get to keep helps the amputee be mobile and independent in later life.
Going through the joint at the knee would be straightforward…but it also means giving up on an extra couple of inches of perfectly good, strong, healthy tibia that would be really helpful when the patient learns to walk again.
Source: I’m an anesthesiologist and watch these operations regularly.
Because limbs are full of blood vessels that need to be identified and tied off, or else the patient will just bleed to death.
If you dissect down to where you know the major vessels are, you can cleanly find them, tie them off, then cut them.
If you just whack the whole thing off with a butcher knife, you will be staring at a ragged bloody mess trying to figure out where those things are.
You also need to close the wound when you’re done. If you do it properly, you’ll have excess muscle and skin beyond the bone you can pull over the bone and sew shut. If you guillotine it, everything is exposed with no good way to close.
There are a lot of answers in here that are completely missing what I would consider to be the most important point.
If you’re going to amputate a limb on a live patient, and you want them to stay that way (alive, I mean), then you need to save enough skin to close the wound once you’re finished or the patient will almost certainly die from the resulting infection. If you just chop a limb off like a butcher, that leaves you with no skin to cover the wound. The cuts must be made in a manner that leaves you with flaps of skin and other tissue that are much longer than the remaining bone which can then be sutured closed to give the patient a closed barrier against infection and a real chance of *not* dying from sepsis.
Many of these operations were done before the discovery of modern anesthetic. Often the best you could do was pour an entire bottle of 80 proof rum down the poor sod’s throat to try and dull the pain, then get three strong men to hold them down while you cut. Getting fancy round the joint while your patient screams and thrashes around would be a nightmare, hence the approach of hacking the limb off and hoping they live.
Because they wanted to keep a pacman shaped bunch of flesh around the cut bone tip, to have some extra meat to sew together over the (possibly sharp) edge of the bone, for padding.
Butchers choose the joints because it’s easier for the butcher, doctors go through bone because it’s easier for the patient. Dead stuff will never be able to walk again anyway, but someone who stood on a mine or had an accident and loses a part of their leg hopefully will, and the more leg is left, the easier it is to learn to walk again.
Y’all must have some smart five year olds
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