RN
Deal with the word first, because it is the reason you are here and nobody else is going to tell you.
"Nugget" is a slur. It is applied to people missing multiple limbs, it is meant to describe a person as an object with no arms or legs, and it is used that way about real people who did not choose the term and object to it. This article's title contains it because the article predates this rewrite and was written to catch the search. Knowing what a word means is not the same as endorsing it, and you can want an honest answer to a question you asked in the only vocabulary you had heard.
So: the term is used online to label pornography involving performers with multiple amputations or congenital limb differences. That is the whole of what it denotes. Everything interesting about the subject is underneath it.
Two words that get swapped, and shouldn't be
Almost all the confusion in this area comes from collapsing two completely separate things.
Acrotomophilia is sexual attraction to people who are amputees. People who identify this way often call themselves devotees. The attraction is directed outward, at other people's bodies.
Body integrity dysphoria is something else entirely: a persistent desire to become disabled oneself, most often by amputation. It is coded 6C21 in the eleventh revision of the International Classification of Diseases, having previously circulated under the name body integrity identity disorder and, earlier and more loosely, apotemnophilia. It is described in the literature as rare, and it is not listed in the DSM-5, which means clinical recognition of it is uneven depending on where you are.
One is an attraction. The other is a recognised condition involving significant distress about one's own body. They are not two flavours of the same thing, they are not causally linked in any established way, and treating them as interchangeable — as the version of this article that stood here did, while calling people in the second category selfish — is both wrong and gratuitously unkind about people who are, by the clinical description, suffering.
What the research actually supports, and how much
There is a frequently repeated set of findings about devotee preferences: legs over arms, single limb over double, a residual limb over none. That comes from a survey published in 1983.
It is worth knowing that this figure exists and it is worth knowing what it is. Forty-odd years old, drawn from people who volunteered themselves from within a niche community, and therefore a description of who answered a questionnaire rather than a measurement of anything about a population. Anyone presenting those preferences as an established fact about a group of people is over-reading a small old study, and the internet repeats it constantly without the caveat.
That is roughly the state of the evidence generally here. The terminology is settled. The prevalence, the causes and the psychology are not.
The part that gets left out
There is a perspective almost entirely absent from writing on this subject, which is that of the people being discussed.
The rehabilitation literature treats this as a practical clinical issue rather than a curiosity: amputees report receiving unwanted sexual attention, being photographed without consent, being approached because of a limb difference rather than despite it, and feeling targeted or unsafe as a result. Clinicians are advised to be ready to support patients dealing with it. That is not a hypothetical harm — it is documented well enough to have become part of professional guidance.
Two things follow, and they are not in tension.
An attraction is not misconduct. Someone attracted to amputees has done nothing wrong by being so, and moral panic about the attraction itself helps nobody, least of all disabled people who would like to be desired like anyone else.
Conduct is a different matter, and the conduct people complain about is specific and avoidable: taking photographs of strangers, approaching someone as a category rather than a person, editing images of real people to fake amputations, and treating a disability as a feature to be consumed. Someone appearing in adult content has consented to being watched in that content. Nobody has consented to being treated as an exhibit for the rest of their life.
If you were looking for the material
The previous version of this article ended by pointing at tube sites. That is not a useful answer and this one will not repeat it, because the relevant point is about sourcing rather than availability.
Adult content involving disabled performers exists, and where performers produce and sell it themselves the consent position is as clear as it is anywhere in this industry. Content scraped, re-uploaded and re-labelled with the slur in the title is a different proposition, and the labelling is itself a reasonable signal about how the people in it are being regarded by whoever posted it.
For adjacent listings that are actually checked, the fetish sites and paid fetish sites are the maintained categories. Neither is a recommendation for this specific search, because a directory listing a category is not the same as a directory vouching for how every performer in it was treated.