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Orthotics > Amputation Types > Flashcards

Amputation Types Flashcards

1
Q

What can be done for transmetatarsal amputation

A

Shoe modifications: has enough length and necessary muscle attachment to remain functional
Extended Foot Plate: steel shank into sole of shoe to allow normal toe off
Toe filler: to fill distal empty toe portion
Rigid Rocker bottom

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2
Q

What type of amputation is the Lisfranc Amputation

A

tarsometatarsal articulation of the foot

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3
Q

In Lisfranc Amputation what is disassociated?

A

Disassociation between the Tarsal bones and Metatarsals

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4
Q

What type of amputation is Chopart?

A

Mid-tarsal Disarticulation

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5
Q

Describe the Chopart Amputation and what is removed

A

Removes the forefoot and midfoot, SAVING TALUS AND CALCANEUS

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6
Q

What type of disarticulation is the Symes Amputation

A

Ankle Disarticulation

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7
Q

Transmetatarsal Amputation

A

Shoe Modification: has enough length and necessary nuscle attachments to remain functional
Extended foot plate: extended carbon fiber foot plate
Toe filler: to fill distal empty toe portion of shoe
Rigid rocker bottom

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8
Q

What type of articulation is the Lisfrant Joint?

A

Type of transmetatarsal articulation of the foot

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9
Q

What is intact with the Lisfranc Joint

A

Calcaneus, Talus, and Tarsal bones

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10
Q

Describe Chopart Amputation

A

Removes the forfoot and midfoot, saving the talus and calcaneus

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11
Q

Example of Ankle Disarticulation

A

Symes Amputation

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12
Q

Describe Symes Amputation

A

amputation at the ankle

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13
Q

Syme’s amputation pt’s may be susceptible to what condition later in life?

A

Knee and hip OA

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14
Q

Advantages of Symes amputation (5):

A 
Distal Weight Bearing
Longer limb=less energy loss
Can ambulate without prosthesis 
Proprioception
Preservation of distal growth plate in children
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15
Q

Disadvantages of Symes amputation (3):

A

Wound healing
Compliance
Heel pad instability

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16
Q

Most important major amputation in VA patient population

A

Transtibial

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17
Q

Describe 2 benefits of transtibial amputations

A
  1. Knee is saved and viable. 2. Ambulation possible with good rehab and prosthetics, even when bilateral
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18
Q

What are the indications for amputation?

A
  1. Peripheral Vascular Disease
  2. Diabetic limb disease
  3. Necrotising fasciitis (rare)
  4. Trauma
  5. Infection
  6. Tumors (Malignant)
  7. Nerve injury (possible diabetic situation, SCI)
  8. Congenital anomalies
    (extra digits, gross deformity)
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19
Q

Who is Ambrose Pare? and what did he do?

A

French surgeon who: stopped using oil for cauterization, developed Ligature with spring loaded forceps, and was the first to describe phantom sensation

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20
Q

Do more males or females have amputations?

A

Males (9:1 Ratio)

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21
Q

What is the most common reason for amputations?

A

Vascular disease (80%)

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22
Q

What are the odds of mortality after 1 and 5 years?

A

1 year = 25%

5 years = 67%

23
Q

What should be included in the pre-op eval?

A
  • pt’s functional status & age
  • Overall medical condition
  • Skin Condition (Temp, Hair Loss, Dystrophic nature)
  • Infection (“deep” vs. superficial)
  • Peripheral pulses
24
Q

What is the difference between chronological age and physiological age?

A
  • -> Chronological - your actual age (The number of years you have lived)
  • -> Physiological - age judged in terms of physiological development
25
Q

What are the 2 most common amputations?

A

Trantibial (BK) - 59%

Transfemoral (AK) - 35%

26
Q

When does a Rotationplasty/Van Ness procedure get used?

A
  • in cases of osteosarcoma and congenital lower-limb differences (proximal focal femoral deficiency)
27
Q

What does a Rotationplasty involve in terms of surgery?

A
  • partial amputation above the knee
  • lower leg and foot are rotated 180 deg, length is adjusted and tibia is fused to the proximal femur
  • foot is where knee used to be , heel portion in front and toes pointing backwards
  • ankle is know functioning as the knee
28
Q

What is the primary reason for the rotationplasty (think function)?

A
  • to enhance the person’s mobility as a prosthesis user

- functional, natural knee is created and the toes provide sensory feedback

29
Q

Is there a cosmetic component/worry to a rotationplasty?

A
  • Yes!
  • appearance is very unusual
  • pts should talk with people who have had this procedure done before
  • functional advantages usually quickly outweigh the appearance
30
Q

Optimal Amputation Level for Transradial (forearm)

A

junction proximal 2/3 and distal 1/3

31
Q

Shortest Amputation Level for Transradial

A

3 cm below biceps insertion

32
Q

Longest Amputation Level for Transradial

A

5 cm above wrist joint

33
Q

Optimal Amputation Level for Transhumeral

A

middle third

34
Q

Shortest Amputation Level for Transhueral

A

4 cm below axillary fold

35
Q

Longest Amputation Level for Transhumeral

A

10 cm above olecranon

36
Q

Optimal Amputation Level for Transfemoral

A

middle third

37
Q

Shortest Amputation Level for Transfemoral

A

8 cm below pubic ramus

38
Q

Longest Amputation Level for Transfemoral

A

15 cm above knee joint

39
Q

Optimal Amputation Level for Transtibial

A

8 cm for every meter of height

40
Q

Shortest Amputation Level for Transtibial

A

7.5 cm below knee joint

41
Q

What is a Forequarter Amputation ?

A
  • the removal of the upper limb with the scapula

- mainly used for malignancy

42
Q

Krukenberg Procedure

A
  • separate radial and ulna rays distally

- forming radial and ulna pincers capable of strong prehension and excellent manipulative ability

43
Q

Define myodesis

A

direct suturing of muscle or tendon to bone

44
Q

When is a myodesis used?

A

transfemoral amputation; distal muscle stabilization gives greater stability

45
Q

When is myodesis not recommended?

A

for ischemic patients; employ myoplasty instead

46
Q

Define myoplasty

A

muscle is sutured to muscle and placed over end of bone before wound closure

47
Q

When is myoplasty used?

A

patients with poor vascular health

48
Q

Which provides better distal stabilization, myodesis or myoplasty?

A

Myodesis

49
Q

Indications for hip disarticulation

A

prevention of life after trauma; co-morbid pt with infection and sepsis; necrotizing fasciitis; non-ambulators (paras); advanced ischemic disease; tumor-osteosarcoma

50
Q

What anatomy is lost in hemipelvectomy?

A

femoroacetabular region and part of pelvis

51
Q

What is a hemicorporectomy?

A

Amputation through part of the trunk

52
Q

What is another name for a rotationplasty?

A

Van Ness procedure

53
Q

Example of a Mid-Tarsal Disarticulation

A

Example of a Mid-Tarsal Disarticulation

Orthotics (11 decks)

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