1.26 Amputation Flashcards
wrapping guidelines
- anchor above proximal joint line
- no creases
- no windows
- figure 8
- check for pain (appropriate pressure)
- no adductor roll for transfemoral
What are the amputation types of the LE?
- toe disarticulation
- transmetatarsal
- ray removal
- ankle disarticulation
- transtibial
- knee disarticulation
- transfemoral
- hip disarticulation
- hemipelvectomy
- hemicorporectomy
- rotationoplasty
Who often gets toe disarticulations?
diabetics
Which is the most important toe to save?
big toe
transmetatarsal amputation
through midsection of tarsals
What does a transmetatarsal amputation affect with respect to gait?
- affects toe off
- abbreviates stance
- faster swing on the opposite side (even shorter when painful)
What is an ankle disarticulation also called?
Syme’s disarticulation
What may be kept with a Syme’s disarticulation?
calcaneus
Why would the calcaneus be kept?
- maintain the same leg length
- with enough padding, can walk with a peg leg
What may be amputated with an ankle disarticulation (Syme’s)?
- may include removal of malleoli
- may leave calcaneus
What is the goal of a transtibial amputation?
- keep the bone as long as possible
- want to same more of the gastroc and wrap around to the front to cushion the bony end
What is the most important thing to keep if at all possible with an amputation?
- the knee
- need a stable knee for proper gait
What is a knee disarticulation?
amputation with the femur intact
Why are knee disarticulations not as common as other types of amputations?
If you try to create a knee joint, it will be below where the normal anatomy would be
transfemoral amputation
- more muscle able to wrap around and attach so they can pull in opposition to one another
- want as long of a femur possible
Why does the femur need to be as long as possible in a transfemoral amputation?
- longer lever arm
- easier to control prosthetic limb
What is a hip disarticulation?
- still has a pelvis, but removes the entire leg
- salvage procedure
prosthetics for his disarticulation
generally locked into knee extension
What is a hemipelvectomy?
get rid of lower half of pelvis
What is a hemicorporectomy?
- get rid of entire pelvis
- salvage procedure
- some people born that way
What is particularly problematic with a hemicorporectomy?
pelvic floor muscles have nothing to act on
What condition is rotationoplasty often used for?
Ewing sarcoma
- typically occurs in young males
- bone cancer that presents in distal femur or proximal tibia during puberty
What is rotationoplasty?
- take the chunk out that’s bad
- rotate foot 180˚
- therapy to reach terminal extension
- foot placement for prosthetic
benefit of rotationplasty
get knee control, essential for gait (PF is now extension)
UE amputations?
can have them, but we don’t see them as much
