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In medical science, disarticulation refers to the accidental or surgical separation of bones at a joint, resulting in the amputation of a limb, without any breaking or cutting of bones. It can be the result of an injury or can be performed surgically. This is different than a fracture, which can result in a loss of a body part due to a broken bone, or joint dislocation, which is the displacement of a joint without complete bone separation and the resulting loss of a limb. For certain surgical amputations, disarticulation is the preferred method of amputation because it improves healing, leaves more muscle and nerve tissue for prosthesis control, and makes it easier to fit a prosthesis. Amputations, including disarticulations, are one of the oldest medical procedures known to have been performed by humans.
An amputation often involves many parts of the musculoskeletal system, sometimes called the locomotor system. This system is made up of the bones, muscles, joints, and other connective tissue that holds the body together and makes physical movement possible. The most common form of disarticulation is surgical amputation, when surgeons cut through skin, ligaments, joints, muscle, and other connective tissue to remove a limb, without cutting the bone itself. Disarticulation is often the preferred method for amputations done at the wrist, knee, and elbow, and is occasionally used at the hip joint.
Amputation by disarticulation has several advantages over cutting the bone. For example, it involves less blood loss, and usually provides skin flaps that can cover the wound after surgery, improving healing and reducing the risk of infection. Disarticulation also preserves more muscle and nerve tissue that can make it easier to control the future prosthesis. In many cases, the preserved bone and joint also provide a better and more stable fit for prosthesis. For knee amputation, this type of procedure will result in preservation of part of the knee joint, providing a stump that can bear more weight than if the bone had been cut.
Injuries to the musculoskeletal system can also result in disarticulation but this is relatively uncommon. In rare cases, disarticulation and amputation can be self-inflicted, for example as a result of deliberate self-mutilation, or in cases where a limb has become trapped in an accident. Sufferers of the rare disorder apotemnophilia feel compelled to amputate one or several limbs, even if those limbs are healthy. Acrotomophilia involves sexual attraction to amputees and is sometimes confused with apotemnophilia.