Amputation

Question 1

What is myodesis? When is it used? Which amputation?

Answer 1

muscle to bone
to provide optimal stability
transfemoral

Question 2

What is myoplasty? When is it used? Which amputation

Answer 2

muscle to muscle or soft tissue
in patients who are ischemic
transtibial

Question 3

What are the types of foot/ankle amputations?

Answer 3

Phalangeal removal
Ray amputation
Transmetatarsal amputation
Lisfranc (tarsomet disarticulation)
Chopart (disartic through midtarsal joint)
Symes (ankle disartic)

Question 4

What are the types of lower extremity amputations

Answer 4

BK (transtibial)
Thru-Knee disarticulation
AK (transfemoral)
Hip disarticulation
Hemipelvectomy
Hemicorporectomy

Question 5

What is the optimal tibia length in a BK?

Answer 5

5-7 inches (less than 3.5 inch is not feasible)

Question 6

What is a rotationoplasty also called? When is it used?

Answer 6

Van Ness procedure

in cases of osteosarcoma and congenital lower-limb differences

Question 7

What are the types of upper extremity amputation?

Answer 7

forequarter (with scapula)
AE
Elbow disartic
BE
Krukenberg (separation of radius and ulna)
Finger

Question 8

What is the timeline for an amputation?

Answer 8

0-2 wks pre-prosthetic training
0-4 wks post operative protector
4-6 wks sutures removed
6-10 wks incision healed, cast for prosthesis
6 wks-4mos temporary prosthesis and gait training
4 mos-8 mos therapy and adjustment
8 mos - 1.5 yrs receive permanent prosthesis

Question 9

What are the primary post-operative care goals (6)?

Answer 9

Reduce edema and promote healing
Prevent contractures
Increase UE and LE strength
Increase mobility and self-care
Promote sound limb care
Assist with limb loss adjustment

Question 10

What kinds of contractures should be avoided?

How can they be avoided?

Answer 10

hip and knee flexion

use stump board in wheelchair, lay prone, support in straight elevated position

Question 11

What are the 5 stages of loss?

Answer 11

Denial Anger Bargaining Depression Acceptance

Question 12

What is nonpainful sensation or awareness experienced that gives form to a body part with specific dimensions, weight, etc.

Answer 12

Phantom sensation

Question 13

What types of sensations do phantom sensations encompass?

Answer 13

Kinesthetic, kinetic, extroceptive

Question 14

What are kinesthetic sensations?

Answer 14

posture, length, volume

Question 15

What are kinetic sensations?

Answer 15

movements

Question 16

What are extroceptive sensations?

Answer 16

touch, temperature, pressure

Question 17

What is a painful sensation experience w/in the limb that is no longer part of the body?

Answer 17

phantom pain

Question 18

What is pain arising in the residual limb from a specific anatomical structure that can be identified?

Answer 18

residual limb pain

Question 19

What does functional level 0 entail?

Answer 19

no ability or potential for weight bearing or transfer

Question 20

What does functional level 1 entail?

Answer 20

ability or potential to transfer and ambulate in household with an AD

Question 21

What does functional level 2 entail?

Answer 21

community ambulator with ability or potential to traverse minor environmental barriers w/ a fixed cadence

Question 22

What does functional level 3 entail?

Answer 22

community ambulator w/ ability or potential to traverse all environmental barriers w/ a variable cadence

Question 23

What does functional level 4 entail?

Answer 23

ability or potential for prosthetic ambulation that exceeds basic skills, exhibiting high impact stress, or energy levels