In Germany there are approximately 18,500 major amputations of the lower extremity each year, primarily transtibial or transfemoral. For successful rehabilitation, knowledge about the desired optimal stump condition and specific amputation techniques are essential. Biomechanical considerations regarding the amputation stump play a crucial role in the selection of the surgical technique as do the reasons for the amputation. Techniques such as myodesis, myoplasty or Gottschalk plastic surgery help to maintain muscle tension and optimize prosthesis control.