Amputations Flashcards
LEAP Study
soft tissue loss is the biggest consideratieon for amputation
loss of plantar sensation is NOT an absolute indication for amputation. Sometimes it returns.
post-amputation, the best predictor of patient reported outcome is:
return to work
what is more energy efficient: syme or midfoot ampuation?
syme’s (despite it being more proximal)
wound healing is improved by:
albumin >3.0g/dL ischemic index >0.5 transcutaneous O2 tension >30mm Hg toe pressure >40mm Hg ABI >0.45
contraindications to hyperbaric O2 therapies
- chemo or radiation therapy
- undrained pneumothorax
- pressure-sensitive implanted device (defibrillator, pacemaker, insulin pump)
- COPD (risk of bleb or pneumo formation)
role of adductor myodesis in transfemoral amputation
- increases energy efficiency
- dynamic muscle balance
- enables prosthesis fitting
Syme amputation requires:
- patent posterior tibial artery
- intact heel pad
- good for gangrene foot in diabetics
Chopart amputation:
midfoot amputation through Chopart’s joint
Main complication = Equinus
- lengthen achilles and transfer TA to talar neck
Deformity after a Lisfranc amputation:
equinovarus due to pull of achilles and the posterior tibial tendon
- avoid by maintain the insertion of the peroneus brevis (base of 5th Met)
most common complication of a pediatric amputation is:
bone overgrowth
- prevent by amputating intra-articularly OR by placing an epiphyseal cap over the medullary canal
what amputation level in the foot is ideal to maintain propulsive activity of the foot?
distal to the metatarsal heads
energy increase for transfemoral amputation:
65% increase
energy increase for bilateral transtibial amputation:
40% increase
what is the most proxmial level of amputation for children to maintain their normal ambulation speed
trans-articular knee amp
what is benefit of Ertl amputation
this is osteomyoplasty - putting a bone bridge between tib-fib in the transtibial amputation
- allows improved end-bearing on a bone surface
