Amputations and Prosthetics Flashcards
Forequarter (scapulothoracic)
removal of UE including the shoulder girdle
- lost of shoulder, elbow and hand function
- most common cause is malignancy
- functional prosthetic use is common
- a lightweight cosmetic prosthetic is typically well tolerated
Shoulder disarticulation
removal of UE through shoulder joint
- loss of all shoulder, elbow, and hand function
- most commonly the result of malignancy or severe electrical injuries
- functional prosthetic use is possible
- an external prosthetic shoulder joint is typically required
transhumeral
removal of UE proximal to elbow
- loss of elbow and hand function
- most commonly due to trauma
- typically 7-10 centimeters proximal to the distal humeral condyles
- trauma associated fracture, dislocation or peripheral nerve injury may delay prosthetic interventions
elbow disarticulation
removal of lower arm and hand through elbow joint
- loss of all elbow and hand function
- most commonly due to trauma
- allows for self-suspending socket
- an external prosthetic elbow joint is typically required
transradial
removal of UE distal to the elbow
- loss of all hand function
- must be a minimum of five centimeters proximal to the distal radius
- typically the result of trauma
- trauma associated fracture, dislocation, or peripheral nerve injury may delay prosthetic interventions
- functionally preferred over wrist disarticulation or selected partial hand amputations
- most common UE amputation
wrist disarticulation
removal of hand through wrist joint
- loss of all hand function
- relatively uncommon level of amputation
- cosmetic and functional prosthetic disadvantage
partial hand
removal of portion of hand and digits at either the transcarpal, transmetacarpal, or transphalangeal level
- loss of a portion of digit/hand function
- limb sparing technique utilized when functional pinch can be perserved
- toe transfer to replace a thumb may be considered if prosthesis fails
digit amputation
removal of digit at MCP, proximal interphalangeal or distal interphalangeal level
- preserved function is highly variable depending on number of digits involved
- prostheses are not typically used
- a long transradial amputation may be more functional if multiple digits are involved at proximal levels
hemicorporectomy
removal of pelvis and both LE
hemipelvectomy
removal of one half of the pelvis and the LE
hip disarticulation
removal of the LE from the pelvis
- all functions of the hip, knee, ankle, and foot are absent
- most common cause is malignancy
- does not allow for activation of the prosthesis through a residual limb
- prosthetic limb advancement initiated through use of pelvis
transfemoral
removal of the LE above the knee
- length of the residual limb with regard to leverage and energy expenditure
- knee componentry will determine ability to functionally reciprocate gait
- stance control may not activate until weight bearing occurs through limb
- donning can be more difficult than with a transtibial amputation
- weight bearing through the ischium in an ischial containment socket
- susceptible to hip flexion contracture
- adaptation required for balance, weight of prosthesis, and energy expenditure
knee disarticulation
removal of the LE through the knee joint
- loss of all knee, ankle, and foot function
- residual limb can weight bear through its end
- susceptible to hip flexion contracture
- knee axis of the prosthesis is below natural axis of the knee
- gait deviations can occur secondary to the malalignment of the knee axis
transtibial
removal of the LE below the knee joint
- loss of active foot and ankle motions
- weight bearing in the prosthesis should be distributed over the total residual limb
- areas of primary weight bearing should be pressure tolerant
- adaptations required for balance
- susceptible to both knee and hip flexion contracture
Symes
removal of the foot at the ankle joint with removal of the malleoli
- loss of all foot function
- residual limb can bear weight through its end
- residual limb is bulbous with a non- cosmetic appearance
- dog ears must be reduced for proper prosthetic fit
- adaptation required for increased weight of the prosthesis
- adaptation required due to diminished toe off during gait
transverse tarsal (Choparts)
removal through the talonavicular and calcaneocuboid joints. preserves the PF but sacrifices the DF resulting in equinus contracture
- loss of forefoot leverage
- loss of balance
- loss of weight bearing surface
- loss of proprioception
- tendency to develop equinus deformity
tarsometatarsal (lisfranc)
removal of the metatarsals. preserves the PF and DF
- loss of forefoot leverage
- loss of balance
- loss of weight bearing surface
- loss of proprioception
- tendency to develop equinus deformity
