Amputation Flashcards
surgical removal of all or part of a limb
Amputation
amputation at the level of the joint; pediatric patients
Disarticulation
amputation due to poor blood supply
Dysvacularization
born with congenital limb deficiency
Congenital Limb Difference
Residual limb AKA
Stump
subcutaneous tissue used to cover the distal end bone
Flap
clinical trimester for limb formation
1st trimester
Causes of Congenital Limb Deficiency
Teratogen agents
Amniotic band syndrome
Rare hereditary implications
complete missing of the limb after a certain point
Transverse Deficiency
Transverse Deficiency AKA
Terminal Deficiency
specific part of the limb is missing
Longitudinal Deficiency
Longitudinal Deficiency AKA
Intercalary Deficiency
Radial Ray Anomaly I
slightly short radius
Radial Ray Anomaly II
very short radius; ulna moves sideways
Radial Ray Anomaly III
partial missing radius
Radial Ray Anomaly IV
complete missing of radius
complete absence of the limb
Amelia
partial absence of the limb
Meromelia
flipper like appendage
Phocomelia
missing metacarpal/metatarsal
Adactyl
half of the limb is missing
Hemimelia
missing fingers/toes
Aphalangia
missing hand/foot
Acheiria
Causes of Acquired Pediatric Amputation
MVA
Electric burn
Thermal burn
Explosion (MC)
Recreation
Causes of UE Amputation
Trauma (MC)
Tumor
Infection
Partial Hand Amputation
Transphalangeal
Transmetacarpal
Transcarpal
Wrist Disarticulation
Resection of Transphalangeal
proximal/middle/distal phalanx
Prosthesis for Transphalangeal
Custom finger
Resection of Transmetacarpal
Distal & Proximal Metacarpal
Prosthesis for Distal Transmetacarpal
Custom hand (stainless)
Prosthesis for Proximal Transmetacarpal
Specialized terminal device/Hook
Resection of Transcarpal
carpal bones
Spared in Transcarpal
wrist flexion, extension
pronation-supination
Spared in Wrist Disarticulation
pronation-supination
TFCC
Radial Amputation of Digits (Resection & Compromised)
Resection: thumb and index finger
Compromised: palmar grasp
Ulnar Amputation of Digits (Resection & Compromised)
Resection: 4th and 5th finger
Compromised: hook grasp
most functional and common amputation
Finger tip
Central Amputation (Removal)
3rd and 4th finger
Thumb Amputation (Compromised)
Lateral prehension
Pinch grip
Power and Palmar grasp
MC UE Amputation with the exception of Fingertip
Transradial (Below Elbow) Amputation
Long Transradial
55-90%
motions available in long transradial
60-120 pronation and supination
strong elbow flexion
motions available in short transradial
60 pronation and supination
decreased elbow flexion
Short Transradial
35-55%
Very Short Transradial
<55%
Socket for Long & Short Transradial
Dual-Walled
Socket for Very short Transradial
Muenster
Harness for Transradial
Figure of 8
Elbow unit for Transradial
Polycentric elbow unit
Control cable system for Transradial
Single control cable
Friction for Transradial
Constant wrist friction unit
Terminal Device for Transradial
Active Terminal Device: 5xa
Elbow Disarticulation
90-100%
Standard Transhumeral
50-90%
Short Transhumeral
30-50%
Humeral Neck Amputation
<30%
Socket for Short & Standard Transhumeral
Dual-Walled extending beyond the acromion process
Socket for Humeral Neck
Dual-Walled extending above the acromion process
Socket for Elbow Disarticulation
Broad & Flat
Suspension for Elbow Disarticulation
Self-suspending
Shoulder Disarticulation (Spared)
Humeral head
Glenoid fossa
Deltoid (Padding & covering)
Forequarter Amputation (Removal)
UE limb
Clavicle
Scapula
Indication of Shoulder Disart. & Forequarter Amputation
Tumor
3rd MC site of Osteosarcoma
Proximal Humerus
MC site for Ewing & Chondrosarcoma
Scapula
Prosthesis for Shoulder Disart. & Forequarter Amputation
Extends onto the thorax
(+) Chest strap
Causes of LE Amputation
Peripheral Arterial Disease (MC)
Trauma
Tumor
Infection
MC Amputation secondary to poor vascular supply
Toe Amputation
Fxnl limitation in Big Toe Amputation
Walking: standing difficulty
Running: limping appearance
Deformity in 2nd toe Amputation
Hallux Valgus
Prosthesis for 2nd toe amputation
Toe fillers
MC Ray Amputation
5th ray
Ray amputation (resection and spared)
Resection: MTT and phalanges
Spared: Base of metatarsal
Orthosis for Ray amputation
Rockerbottom
Carbon foot plate
Transmetatarsal (resection and spared)
Resection: metatarsal/forefoot
Spared: base of MTT
Lisfranc (resection)
Resection: MTT + Phalanges + Base of MTT
Lisfranc
Tarsometatarsal
Deformity in Lisfranc
Pes Equinovarus
Prosthesis for Lisfranc
AFO (active patients)
Carbon foot plate with toe fillers
MC level of amputation secondary to traumatic injury
Chopart/Transtarsal
Chopart (resection and spared)
Resection: Tarsal bones
Spared: talus & calcaneus
Deformity in Chopart
Pes Equinovarus
Boyd
Talectomy + Calcaneotibial fusion + Forward translation of tibia
Pirigoff
Talectomy + Calcaneotibial fusion + Forward and upward trans of calcaneus
Symes
transection 1.3 cm above the malleoli
Long Transtibial/BKA
> 50%
Medium Transtibial/BKA
20-50%
Short Transtibial/BKA
<20%
self-suspending due to femoral epicondyles
Knee Disarticulation
Long Transfemoral/Above Knee
> 60%
Medium Transfemoral/Above Knee
35-60%
Short Transfemoral/Above Knee
<35%
femur is less than 5 cm
Hip Disarticulation
Prosthesis for Hip Disarticulation
Canadian Hip Disarticulation
Components of Canadian Hip Disarticulation
Socket: encompasses the hemipelvis
Shank: endoskeleton
Knee: constant friction
FAA: shank
removal of half of the pelvis
will not require prosthesis for ambulation
Hemipelvectomy
Prosthesis for Hemicorporectomy
Bucket-shaped
Hemicorporectomy (removal)
LE limb
Pelvis
Transection at the lumbar spine
External genitalia
Flap (Criteria)
Broad
Painless
Pliable
equal length of anterior and posterior flap
Fishmouth
Long Posterior Flap
Burgess
Bruckner
Burgess (landmark)
Medial and lateral gastrocs
Bruckner (landmark)
Medial gastrocs
attachment of muscle to bone
Myodesis
attachment of muscle to muscle
Myoplasty
Stump (Criteria)
Painless
Healed and matured
Prosthetically ready
Prevents edema formation
Shrinkage
- Bandage (least effective)
- Juzo Compression Garment
Care Pathway LE Amputation Day 1
In-Bed
Respiratory care
Pain control exercise
Joint ROM
Care Pathway LE Amputation Day 2
Sit out in Chair
ROM
Strengthening (limbs and trunk)
Balance training
Transfer practice & W/C provision
Edema control
Care Pathway LE Amputation Day 3
Independence
Continue ROM, Strengthening, Balance exercise
Pain and edema control
Functional exercise (bridging, personal care, standing, w/c supported)
Postural correction
Care Pathway LE Amputation Day 4-7
Discharge Planning
Plan home visit with OT
Monitor edema control
Continue exercise program and mobility
Ensure appropriate clothing for rehab
Care Pathway LE Amputation Day 7-14
Prosthetic Assessment
Attend gym environment
Individual and group exercise session
Assessment and practice early walking aids
Prepare for prosthetic rehab (stump, shape, proprioception, strength)
Care Pathway LE Amputation Day 14-28
Develop Appropriate Plan
Progress rehab program
Care Pathway LE Amputation Week 4-6
Outpatient/Community
Cast/Prosthesis
Start prosthetic training
Ensure re-integration into home environment
Transtibial contracture
Knee flexion
Transfemoral contracture
Hip flexion and abduction
Phantom Pain
Burning
Crushing
Cramping
Dull aching
Electrical
Leg is being pulled off
Phantom Sensation
Pressure
Itching
Coldness
Residual Limb Pain
Joint, Muscle, Bone pain
Neuroma
Dressing for easy wound inspection
Soft Dressing
Dressing that promotes knee extension
Rigid Dressing
Dressing for early gait training
IPOP (Immediate Post-op Prosthesis)