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Prosthetics > 1: Introduction to Amputations > Flashcards

1: Introduction to Amputations Flashcards

1
Q

What is the definition of an amputation?

A

Surgical removal of a body part (partial or full) due to disease, trauma, or injury

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2
Q

What is a prosthesis?

A

Replacement of all or part of the extremity removed

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3
Q

Are men or women more likely to have an amputation?

A

Men (65%)

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4
Q

50% of people who have an amputation due to vascular disease will die within how many years?

A

5 years

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5
Q

55% of people who have an amputation due to diabetes will have a second amputation within how long?

A

2-3 years

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6
Q

Which is more likely to be amputated? LE or UE?

A

LE is 11x more likely to require an amputation

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7
Q

What are the three health-related risk factors for amputation?

A

Diabetes, hypertension, dyslipidemia

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8
Q

What is the leading cause of LE non-traumatic amputations?

A

Diabetes

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9
Q

What is the second leading cause of amputation?

A

Trauma - young adults, machinery, power tools, appliances, firearms, MVA

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10
Q

What is the third leading cause of amputation?

A

Cancer - primary or secondary due to metastatic disease

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11
Q

What are examples of non-traumatic amputation?

A

PVD, diabetes, limb deficiencies, congenital, infection, tumor, disease

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12
Q

What are common causes of amputation in children?

A

Congenital limb deformities, tumors, trauma, infection

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13
Q

What is limb preservation?

A

Surgical procedure involving re-vascularization, bone grafting, flag coverage, repair of nerves, compartment syndrome, skeletal stabilization

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14
Q

What three factors determine the level of an amputation?

A
  1. Ability to heal successfully at the incision based on adequate circulation
  2. Removal of all non-viable tissues, structures, especially in the presence of infection
  3. Achieve long term functional residual limb, restore to some level of activity without pain
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15
Q

What are the goals of surgically amputating an limb?

A

Maintain the most adequate length of the residual limb, protest neurovasculature, muscle stabilization, scar and skin, functional shape of residual limb

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16
Q

How are neuromas prevented during surgical amputation?

A

Major nerves are cut high and retract into the soft tissue

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17
Q

What is ligation?

A

Type or closing off of major arteries and veins, cauterization of smaller vessels

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18
Q

What side of the body with the skin flap originate from and why?

A

Posterior because the tissue typically has a better blood supply

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19
Q

Define myofascial

A

Surgically connecting muscle to skin

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20
Q

Define myoplasty

A

Surgically connecting muscle to muscle

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21
Q

Define myodesis

A

Surgically connecting muscle to bone

22
Q

Define tenodesis

A

Surgically connecting tendon to bone

23
Q

What are the 8 common complications following amputation?

A

Neuroma, psychological impact, wound infection, contracture, DVT, phantom limb, phantom pain, hypersensitivity

24
Q

What is a neuroma?

A

Bundle of nerve endings that group together and can produce pain due to scar tissue and pressure from the prosthesis

25
Q

What is the psychological impact of amputation?

A

Denial, grief, anxiety, depression, suicidal ideation

26
Q

Why can contractures develop after amputation?

A

Failure to initiate full ROM early in post-op phase and poor positioning

27
Q

Describe phantom limb

A

Painless sensation where the pt feels that their limb is still present. Commonly occurs immediately after amputation and subsides with desensitization and prosthetic use

28
Q

Describe phantom pain

A

Perception of pain stimulus distal to amputation level

29
Q

Why is decreasing hypersensitivity following amputation important

A

Can impede or prevent fit and functional use of prosthesis

30
Q

What three factors increase the risk of re-amputation?

A

Previous amputation, level of amputation, comorbidities

31
Q

What are 6 common causes of amputation?

A
  1. Diabetes
  2. PVD
  3. Tumor
  4. Infection
  5. Burns
  6. Trauma
32
Q

What are three complications of diabetes that can lead to amputation?

A

Macrovascular problems, microvascular problems, neurological problems

33
Q

What are the four principles related to amputation in children?

A
  1. Preserve the proximal joints - hip and knee
  2. Preserve length and growth plates
  3. Amputate through the joint if the distal bone cannot be salvaged
  4. Proximal osteotomies or external fixation techniques may be needed to accommodate growth
34
Q

What is the level of the amputation dependent on?

A

Vasculature status of the limb, neuropathy, infection, necrosis, malignancy, bone and joint condition, age, function, rehab potential

35
Q

What is preserved with a Lisfranc amputation?

A

Both dorsiflexors and plantarflexors

36
Q

What is preserved and sacrificed with a transverse tarsal amputation?

A

Plantarflexors are preserved and the dorsiflexors are sacrificed

37
Q

What is the location of a Symes amputation?

A

Removal of the foot and ankle with the removal of the malleoli

38
Q

Describe the K0 classification level

A

Prosthesis will not enhance the QOL or mobility. Pt is not eligible for prosthesis for knee or foot unit

39
Q

Describe the K1 classification level

A

Transfers, ambulate on level surfaces, fixed cadence. Limited or unlimited household ambulator

40
Q

Describe the K2 classification level

A

Transfers low-level barriers, curbs, stairs, uneven surfaces. Limited community ambulator

41
Q

Describe the K3 classification level

A

Variable cadence ambulator, transverse most environmental barriers, prosthetic use beyond simple locomotion. Unlimited community ambulator

42
Q

Describe the K4 classification level

A

Exceeds basic ambulation skills, high impact, stress, or energy levels. Typical of child, athlete, or active adult

43
Q

What is the L Test and what is the basic procedure?

A

Functional mobility measure adapted from the TUG. Pt is in a chair, walks 3 m, turns 90 degrees, walks 7 m, then goes back

44
Q

What are the measures of the L Test?

A

Time and quality of gait pattern

45
Q

What is the MCID of the L Test?

A

4.5 seconds

46
Q

What is the AMP Test assess?

A

Variation of transfers, mobility, balance, gait, and stair assessment

47
Q

What is the AMP Test score associated with?

A

Directly related to K levels

48
Q

What is the MDC for the AMP for unilateral lower limb amputation?

A

3.4 points

49
Q

What does the PEQ assess?

A

VAS scale to evaluate the prosthesis and life

50
Q

What are the categories on the PEQ?

A

Satisfaction, well-being, frustration, pain, residual limb health

51
Q

What is the OPUS and what does it assess?

A

Simple survey assessing functional status, QOL, satisfaction

52
Q

What is the TAPES-R and what does it assess?

A

Multi-dimensional tool that assessed activity restriction, psychosocial adjustment, satisfaction with prosthesis, and factors influencing health

Prosthetics (13 decks)

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