Amputation

Question 1

what determines the location of amputation?

Answer 1

usually at the most distal site of viable vascular supply

try to maintain greatest bone length for optimal prosthetic fitting and functionality

Question 2

what physical properties are important in a residual limb?

Answer 2

pliable, pain-free, with non-adherent scarring

broad stabilization flaps

surgical/therapeutic stabilization of major muscle groups

Question 3

What is Neuroma?

Answer 3

a collection of nerve cells in the end of the residual limb

Question 4

What does Hemostasis Care do?

Answer 4

prevents compromised circulation in the distal limb

Question 5

What’s different about Traumatic Amputations?

Answer 5

surgeon must work to preserve as much bone and other tissue as possible

must also be sure to treat for potential infection

Question 6

What 3 main factors can slow healing?

Answer 6

Infection

Smoking

Co-morbidities (vascular problems, diabetes, renal diseal, cardiac disease)

Question 7

What are the 2 phases of Rehab?

Answer 7

Post-operative phase

Prosthetic Training

Question 8

What are the goals of Post-Operative Rehab?

Answer 8

Limit post-op edema, promote residual limb healing

prevent joint contracture and integumentary disturbances

maintain/regain ROM and strength

Adjust to the loss of the body part **emotionally and functionally

Prescrive, provide, and train with medical equipement

Question 9

What are the different kinds of post-operative dressings?

Answer 9

Rigid: removable, immediate post-op prosthesis

Semi-Rigid

Soft: elastic wraps and shrinkers

Question 10

What must be assessed before the amputation?

Answer 10

Pre-amputation level of function

condition of intact lower extremity

mobility

feelings about amputation

pain, ROM, strength

status of residual limb

Question 11

Why is it important to take the patient’s feelings about amputation into consideration?

Answer 11

Whether or not the patient is motivated to get back to “normal” can play a HUGE role in how well and fast they progress through rehabilitation

Question 12

What characteristics of the residual limb are important for functionality?

Answer 12

Circumference

Shape

Skin Condition

Sensation

Joint proprioceptio (does it exist above the amputation)

Appearance of the incision

Question 13

What is a phantom limb? why does it present such problems during rehab?

Answer 13

Phantom Limb: the sensation of still having the amputated portion of the limb

**not ncessarily painful

Very hard to treat, Physical Therapy has only varied success

neurological treatments have been more successful recently

Question 14

How do we care for the residual limb?

Answer 14

manage edema

influence shape with shrinkers or bandaging

positioning for comfort and skin health

desensitization

contracture management

therapeutic exercise

Question 15

what can we do about ambulation?

Answer 15

We may not need to wait for the patient to have a prescribed prosthesis

if necessary, we can use temporary prostheses for practice purposes

must also remember to choose the most appropriate assistive device base on patient skill/strength level

Question 16

What information does the Patient need in order to perform self-care?

Answer 16

positioning, edema control, and prosthesis management

limb and skin care

info about the disease process

Therex

Question 17

What is Prosthetic Potential dependent upon?

Answer 17

Depends on situation of each individual: stregnth, endurance level, reason/placement of amputation, etc.

Trans-tibial amputees are most likely to do well in rehab

there are higher physiological demands for trans-femoral or high amputations, especially bilateral