Amputation

Question 1

Who is the highest incidence of amputation?

Answer 1

Native American males

Question 2

What are the leading causes of amputation?

Answer 2

vascular diseases (54% ie DM)
trauma (45%)
cancer (2%)

Question 3

What is the mortality rate within 5 years of amputation?

Answer 3

50%

Question 4

What 2 senses are lost first for a DM pt? and where in the column is that?

Answer 4

loss of vibratory and light touch sense; DCML

Question 5

Why do DM get hammer toe and loss of arch?

Answer 5

motor neuropathy; loss of intrinsic muscles that off set pully system, and flexors take over

Question 6

How much ROM do you need at the big toe for normal gait? and what results if not normal?

Answer 6

Need 60 deg for push off

less than 45 results in less rocker at the foot

Question 7

What is the most common form of amputation for pt with PVD?

Answer 7

Transtibial

Question 8

What is considered short for transtibial? and it’s impact?

Answer 8

2-4 inches

short lever arm impacts knee stability

Question 9

What is considered normal for transtibial? and it’s impact?

Answer 9

5-6 inches

N/A

Question 10

What is considered long for transtibial? and it’s impact?

Answer 10

8+ inches

better torque & Lever arm BUt harder prosthetic fitting

Question 11

Who is the most common demo for transfermoral amputation?

Answer 11

infections

Question 12

What is considered short for tranfem? and it’s impacts?

Answer 12

3-4 inches

loss of lever arm and lower stability at the hip

Question 13

What is considered normal for tranfem?

Answer 13

8-10 inches

Question 14

What are sinus tracks, and what can they cause?

Answer 14

pinholes near wound, and it can cause osteomyelitis

Question 15

What 3 assessments you can use on

Answer 15

Functional Outcome Scales:
AMP: amputee mobility predictor
Quality of life scales

Question 16

What are 2 soft wrappings for residual limb?

Answer 16

ace wrap or shinker

Question 17

What is a semirigid wrapping for residual limb?

Answer 17

plastic made by orthoptist or air cast

Question 18

What is a rigid wrap for residual limb?

Answer 18

serial cast

Question 19

What is the requirement that lets you know you are ready for a prosthesis?

Answer 19

when <1.5 cm difference from tib tub and distal end

Question 20

How do you transfer first for amputee?

Answer 20

to towards intact side first

Question 21

When is sliding board used?

Answer 21

for bilateral amputee

Question 22

ROM goals for knee?

Answer 22

0-120

Question 23

ROM goals for hip?

Answer 23

10-0-100

Question 24

What is Osseo-integrated fixation?

Answer 24

metal pylon goes right into bone, allows for vibratory sense and has best ABC score and balance

Question 25

When do you add a sock?

Answer 25

when limb shrinks | or when there's red marks inferior border of patella or fibular head.

Question 26

When do you take off sock?

Answer 26

limb is not in socket enough | or when there's red marks on tibial tubercle, or fib head

Question 27

Fitting needs during sitting?

Answer 27

clear hamstrings

Question 28

Fitting needs during standing?

Answer 28

good patella orientation | clear lateral walls and pressure points

Question 29

Excessive knee flexion can be due to what three things?

Answer 29

excessive DF excessive ant socket over foot excessive stiff heel/cushion flexion contracture***

Question 30

lacking knee flexion can be due to what 5 things?

Answer 30

``` excessive PF excessively post socket over foot excessive soft heel/cushion anterior/distal discomfort weak quads habit**** ```

Question 31

excessive lateral thrust can be due to what 2 things?

Answer 31

excessive medial placement of prosth foot | abducted socket

Question 32

What does ABC score stand for?

Answer 32

Activities-specific Balance Confidence

Question 33

What is MDC for AMP (amputee mobility predictor) assessment?

Answer 33

3.4

Question 34

What is MDC for TUG?

Answer 34

3.6 sec

Question 35

What assessment correlates with K level for Medicare?

Answer 35

AMP

Question 36

What is K0?

Answer 36

no potential to ambulate therefore no prosthesis

Question 37

What is K1?

Answer 37

limited potential for ambulation used for transfers

Question 38

What is K2?

Answer 38

Ability to transverse low level barriers, can have unlimited household amb

Question 39

What is K3?

Answer 39

Amb at variable cadences (unlimited community amb)

Question 40

What is K4?

Answer 40

beyond basic amb/ specialized

Question 41

What are 3 main things to work on as PT with new prosthesis?

Answer 41

forward progression stance stability energy conservation

Question 42

What is heel, ankle, and forefoot rocker used for?

Answer 42

heel: absorption ankle: transition forefoot: propulsion

Question 43

narrow base gait can be due to what 2 things?

Answer 43

excessive medial placement of prosth foot | improper lateral tilt of socket

Question 44

Pistoning is due to what?

Answer 44

loss of suspension

Question 45

Abducted gait is due to what?

Answer 45

LLD too long high medial wall abd contractures

Question 46

Circumducted gait is due to what?

Answer 46

LLD too long too much friction in knee component lack of confidence abd contracture

Question 47

lateral trunk bend is due to what?

Answer 47

LLD too short high medial wall poor balance weak abductors

Question 48

Vaulting is due to what?

Answer 48

``` LLD toolong weakness too much friction inadequate suspension: vault in intact limb fear habit pain ```

Question 49

Increased metabolic cost for TTA and TFA?

Answer 49

10-20% for TTA | 80% or more for TFA