Amputations

Question 1

Dysvascular amputations

Answer 1

Diabetes – number is amputations related to DM is expected to rise with more people experiencing loss of limb

Question 2

Surgical amputation

Answer 2

Used when conventional methods no longer work for the client

Question 3

Role of OTA

Answer 3

Close supervision due to the need for changes that occur frequently during
treatment as well as the complexity of the problems that may be encountered

Question 4

Above elbow

Answer 4

Transhumeral (short and long)
* Short = loss of all hand, wrist, elbow function and no shoulder rotation
* Long – loss of hand, wrist, elbow function but good shoulder functions

Question 5

Below elbow

Answer 5

• Transradial (short and long)
• Short = loss of hand, wrist, pronation and supination; reduce force of elbow flexion
• Long = loss of hand, wrist and most forearm pronation/supination; force of elbow flexion is good

Question 6

Postoperative care:

Answer 6

• Wound care
• Skin integrity
• Joint mobility
• Reduction of edema
• Prevention of scarring
• Control of pain

Question 7

Postoperative complications

Answer 7

• Neuromas-”pinched nerve” or a nerve tumor
• Phantom Sensations
• Numbness, tingling, temperature changes, pressure, itching, cramps
• Phantom Limb Pain
• Contractures
• Weakness
• Skin breakdown

Question 8

Advantages of early fit:

Answer 8

• Edema control
• Decreased phantom limb pain
• Keep two handed function
• Decreased length of hospital stay
• Prosthetic use and acceptance
• Improved psychological adjustment

Question 9

Some thoughts on bilateral amputations

Answer 9

Provide universal cuff in any residual limb is long enough
* Fit with a temporary prosthesis on at least one limb early
* Can start to teach use of feet, chin, knees and teeth if necessary

Question 10

Types of prosthetics

Answer 10

• Body-powered/Mechanical
• Stump sock
• Harness
• Cable and components
• Socket

Question 11

Wrist Unit – four types

Answer 11

Friction lock
* Quick disconnect
* Locking unit
* Wrist flexion

Question 12

Terminal Device (TD)

Answer 12

• Passive = Cosmetic
• No moveable parts
• No function other than gross assist
• Static grasp pattern
• Active = Function; Hook vs. Hand

Question 13

Hook

Answer 13

• Aluminum
• Lyre-shaped
• Neoprene or polyethylene
  gripping surface
• Pressure for grasp graded with
  rubber bands

Question 14

Hand

Answer 14

Looks like a hand
* Controlled by same cables as
controls the hook
* Sacrifices grip force

Question 15

Myoelectric Prosthesis

Answer 15

Controlled by electrical impulses from the muscles
-* Muscles in residual limb contract voluntarily, motor is activated by the signal and the hand, wrist, elbow etc move into action

Question 16

Prosthetics Training Program

Answer 16

• Initial Phase
• Donning and doffing
• Coat method
• Pull over method
• Wearing time
• Limb Hygiene
• Competency knowledge
• Care of prosthesis

Question 17

Prosthetic Functional Use Training

Answer 17

Complete activities within a reasonable amount of time while using minimal extraneous
movements and energy expenditure

Question 18

Syme’s amputation

Answer 18

loss of ankle and
foot function

Question 19

Types of Prostheses

Answer 19

• Pylon
• C-leg
• Adjusts itself dynamically

Question 20

OTs role in LE amputations

Answer 20

• Positioning/Hygiene
• Above knee – flexion, external rotation, and abduction of hip
• Below knee – external rotation and flexion of knee
  Dynamic balance/pain
• Driving
• Prevoc and vocational activities
• Leisure/driving
• Reintegration