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PTRS 746 - Musculoskeletal > Amputation Management and Rehabilitation > Flashcards

Amputation Management and Rehabilitation Flashcards

1
Q

Peripheral Vascular Disease

A
  • Often associated with diabetes and/or smoking

- Diabetes increases the risk of intermittent claudication (cramping) by 4-5 times

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2
Q

Dysvascular Amputation

A

-Most amputations in those with diabetes are preceded by a foot ulceration

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3
Q

Traumatic Amputation

A
  • Can be MVA, work/violence related, severe burns, etc.

- More common among younger men

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4
Q

Amputation vs. Salvage

A
  • Lifetime cost of amputation is 3x higher
  • Risk of hospitalization is greater after salvage
  • Amputation may result in better fxnl outcomes
  • Salvage may be more psychologically acceptable
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5
Q

Pediatric Amputation

A
  • 3:2 male:female
  • 60% congenital
  • Disarticulation minimizes growth plate disruption
  • Must consider longitudinal and circumferential growth
  • Excellent circulation enhances wound healing
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6
Q

Syme’s Amputation

A

Ankle disarticulation with preservation of heel pad

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7
Q

Hemicorporectomy

A

Amputation of both LEs and pelvis below L4-L5

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8
Q

Forequarter amputation

A

Amputation of humerus, scapula, clavicle

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9
Q

Amputation is among the _______ medical procedures

A

oldest

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10
Q

Muscle length must be preserved to prevent:

A

Contracture and Atrophy

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11
Q

Muscle Stabilization Techniques (5)

A
  • Myodesis
  • Tenodesis
  • Myofascial
  • Myoplasty
  • Open (guillotine)
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12
Q

Myodesis

A

Transected muscles are re-attached by suturing through drill holes at distal end of the bone

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13
Q

Tenodesis

A

Intact tendons re-attached to bone

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14
Q

Myofascial

A

Fascial envelope is sutured over transected muscles

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15
Q

Myoplasty

A

Suturing of one muscle group to its antagonist

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16
Q

Osteomyoplasty

A
  • Used in transtibial amputation
  • Flap is harvested from amputated tibia
  • Stabilizes distal tibia and femur (prevents “chopsticking”)
17
Q

Post-op Complications

A
  • Contracture
  • Edema
  • Phantom limb sensation or pain
  • Personal grief and depression
  • Surgical complications
18
Q

Goals of Acute Rehab (5)

A
  • Prevent complications and allow healing
  • Develop limb strength and ROM for prosthesis
  • Maximize independence in mobility and ADLs
  • Pre-prosthetic training and limb preparation
  • Endurance training and initiation of HEP
19
Q

Post-surgical Phase components (4)

A
  • Compression
  • ROM
  • Positioning
  • Endurance
20
Q

Post-op Dressings (4)

A
  • Rigid Dressing
  • Rigid Removable Dressing
  • Semi-Rigid Dressing
  • Soft Dressing
21
Q

Rigid Dressing

A
  • Immediate Post-Op Prosthesis
  • Plaster socket with removable pylon and foot
  • Limits edema, reduces pain, prevents contracture, allows early weight-bearing and gait
22
Q

Rigid Removable Dressing

A
  • After suture/staple removal, a polypropylene or cast is fit from an impression of the residual limb
  • The RRD is worn over the wound dressing or compression socks
  • Allows skin inspection, provides consistent pressure, easily donned, protects residual limb
23
Q

Semi-Rigid Dressing

A
  • Zinc-oxide, gelatin, glycerin, and calamine compound
  • Applied in OR or PACU
  • Controls edema, adheres to skin, allows some ROM, breathable, inexpensive, easy to contour
24
Q

Soft Dressing

A
  • Incision dressed with 4x4’s and Kerlix
  • Compression provided with ACE bandages or elastic shrinker
  • Inexpensive, Lightweight, Readily available
25
Q

ACE Wrapping

A
  • Must be rewrapped every 4-6 hours
  • Distal to proximal pressure gradient
  • Figure-8 pattern to prevent tourniquet effect
  • Medial to lateral
26
Q

Limb Shrinkers

A

Elastic socks that help decrease edema and assist in shaping the residual limb

27
Q

Limb Socks

A

Used b/w residual limb and prosthetic socket for protection, friction absorption and to fill socket volume

28
Q

Phantom Limb Sensation

A
  • Painless awareness of the amputated body part
  • Incomplete sensation, often mild tingling
  • This is NORMAL
29
Q

Phantom Limb Pain

A
  • Painful sensation of the amputated body part
  • Can be constant or intermittent
  • Described as cramping, squeezing, burning or shooting pain
30
Q

Interventions for Phantom Pain (6)

A
  • Desensitization and massage
  • Compression
  • Exercise
  • Limb handling and use
  • Modalities: TENS, US
  • Psychological counseling
31
Q

Mirror Therapy

A
  • Pt. performs a movement with the unaffected limb
  • Movement is viewed in mirror positioned in front of pt.
  • Simultaneously, pt. attempts to perform the movement with their residual or phantom limb

PTRS 746 - Musculoskeletal (9 decks)

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