amputations and prothetics Flashcards
forequarter (scapulothoracic)
surgical removal of the upper extremity including the shoulder girdle
Shoulder disarticulation
surgical removal of the upper extremity through the shoulder
transhumeral
surgical removal of the upper extremity proximal to the elbow joint
elbow disarticulation
surgical removal of the lower arm and hand through the elbow joint
transradial
surgical removal of the upper extremity distal to the elbow joint
wrist disarticulation
surgical removal of the hand through the wrist joint
partial hand
surgical removal of a portion of the hand and or digits at either the transcarpal, transmetacarpal or transphalangeal level
digital amputaion
surgica lremoval of a digit at either metacarpophlangeal, proxiamal interphalangeal or distal interphalangeal level
hemicorporectomy
surgical removal of the pelvis and both lower extremities
hemipelvectomy
surgical removal of one half of the pelvis and the lower extremity
hop disarticulation
surgical removal of the lower extremity from the pelvis
ransfemoral
surgical removal of the lower extremity above the knee joint
knee disarticulation
surgical removal of the lower extremity
transitibal
surgical removal of the lower extremity below the knee joint
syme’s
surgical removal of the foot at the ankle joint with removal of the malleoli
verse tarsal (chopart’s)
amputation through the talonavicular and calcaneocuboid joints. The amputation preserves the plantar flexors, but sacrifices the dorsiflexors often resulting in an equinus contracture
tarsometatarsal (lisfanc)
surgical removal of the metatarsals. The amputation preserves the dorsiflexors and plantar flexors.
Sockets for transradial
standard socket covers 2/3 of forearm
standard sockets may be shortened to allow for increased pronation/supination ability
supracondylar sockets are self-suspending and require no additional harness apparatus
socket for transhumeral
extends to acromion level
modified design allows for more stability with rotational movement
lightweight friction units may be used with passive prosthetic arms
suspension for transradial
triceps cuff
harness
cable system
suspension for transhumeral
harness
cable system
suction
elbow unit for transradial
attaches to either triceps cuff or upper arm pad
flexible or rigid hinge connects sockets to proximal component
elbow unit for transhumeral
internal or external locking elbow unit
wrist unit for transradial
quick change unit
wrist flexion unit
ball and socket
constant friction
wrist unit for transhumeral
quick change unit
wrist flexion unit
ball and socket
constant friction
terminal device for transradial
voluntary opening or closing
body powered, externally powered, myoelectric or hybrid
hook, mechanical hand, cosmetic glove
terminal device for transhumeral
voluntary opening or closing
body powered, externally powered, myoelectric or hybrid
hook, mechanical hand, cosmetic glove
Socket for transfemoral
quadrilateral socket
ischial containment sockete
Socket for transfemoral
quadrilateral socket
ischial containment socket
socket for transtibial
patella tendon bearing socket (PTB)
supracondylar patella tendon socket (PTS)
supracondylar - suprapatellar socket (SC-SP)
suspension for transfemoral
lanyard strap
shuttle lock
suction - seal in liner suction or skin fit suction
partial suction - Silesian bandage or pelvic belt/band
vacume
suspension for transtibial
supracondylar cuff
thigh corset
supracondylar brim
rubber/neoprene sleeve suspension
waist belt with fork strap
suction with knee sleeve
shuttle lock
vacume
knee for transfemoral
single axis knee
polycentric knee
hydraulic knee
microprocessor knee
knee for trantibial
not needed
shank for tranfemoral
exoskeleton - rigid exterior
endoskeleton 0 pylon covered with foam
shank for transtibial
exoskeleton - rigid exterior
endoskeleton 0 pylon covered with foam
foot system for transfemoral
solid ankle cushion heel (SACH)
stationary attachment flexible endoskeleton (SAFE)
single axis
multi-axial
hydraulic
powered
dynamic response
foot system for transtibial1
solid ankle cushion heel (SACH)
stationary attachment flexible endoskeleton (SAFE)
single axis
multi-axial
hydraulic
powered
dynamic response
advantage of rigid (plaster or Paris)
allows early ambulation with pylon
promotes circulation and healing
stimulates proprioception
provides protection
provides soft tissue support
limits edema
ability to utilize an IPOP (immediate post-operative prothesis)
disadvantage of rigde (plaster of paris )
immediate wound inspection is not possible
does not allow for daily dressing change
requires professional application
advantage of non weight bearing rigid removable limb protectors
removable
accommodates edema fluctuation
easily applied
prevents contracture
provides protection
disadvantage of non weight bearing rigid removable limb protectors
not for ambulatory purposes
advantages for semi-rigid (unna paste, air splint)
reduces post operative edema
provides soft tissue support
allows for earlier ambulation
provides protection
easily changeable
disadvantage for semi-rigid (unna paste, air splint)
does not protect as well as rigid dressing
requires more changing than rigid dressing
ma loosen and allow for development of edema
advantage of soft (ace wrap shrinker)
reduces post operative edema
provides some protection
relatively inexpensive
easily remove for wound inspection
allows for active joint range of motion
disadvantage for soft (ace wrap shrinker)
tissue healing is interrupted by frequent dressing changes
joint range of motion may delay the healing of the incision
less control of residual limb pain
cannot control the amount of tension in the basndage
risk of torniquet effect
shrinker cannot be applied until sutures staples are removed
pre-prosthetic phase
about 6 weeks
focuses on protecting limb, preventing contractures, developing single limb mobility skills, prepare patient for prosthetic phase
anchor wrap above ___ for transtibial amputations
knee
anchor wrap around ___ for transsfemoral amputations
pelvis
use __ in wrap for UE amputation
2-4
use __ in wrap for transtibuial amputation
3-4
use __ in wrap for transfemoral amputation
6
neuroma
bundle of nerve ending that group together and can produce pain due to scar tissue, pressure form the prothesis or tension on the residual limb
lateral bending prosthetic causes
prosthesis too short
improperly shaped lateral wall
high medial wall
prothesis aligned in abduction
lateral bending amputee causes
poor balance
abduction contracture
improper training
short residual limb
weak hip abductors on prosthetic side
hypersensitive and painful residual limb
abducted gait prosthetic causes
prosthesis tooo long
high medial wall
poorly shaped lateral wall
prosthesis positioned in abduction
inadequate suspension
excessive knee friction
abducted gait for amputee causes
abduction contracture
improper training
adductor roll
weak hip flexors and adductors
pain over lateral residual limb
circumducted gait prosthetic causes
prosthesis too long
excessive knee friction
socket too small
excessive plantar flexion
circumducted gait amputee causes
abduction contracture
improper training
weak hip flexors
lacks confidence to flex the knee
painful anterior distal residual limb
inability to initiate prosthetic knee flexion
excessive knee flexion during stance prosthetic causes
socket set forward in relation to foot
excessive dorsiflexion
stiff feel
prosthesis too long
excessive knee flexion during stance amputee causes
knee flexion contracture
hop flexion contracture
pain anteriorly in residual limb
decreased in quadriceps strength
poor balance
vaulting prosthetic causes
prosthesis too long
inadequate socket suspension
excessive alignment stability
excessive plantar flexion
vaulting amputee causes
residual limb discomfort
improper training
fear of stubbing toe
short residual limb
painful hip residual limb
rotation of forefoot at heel strike prosthetic causes
excessive toe-out built in
loose fitting socket
inadequate suspension
rigid SACH heel cushin
rotation of forefoot at heel strike amputee causes
poor muscle control improper training
weak medial rotators
short residual limb
forward trunk flexion prosthetic causes
socket too big
poor suspension
knee instability
forward trunk flexion amputee causes
hip flexion contracture
weak hip extensors
pain with ischial weight bearing
inability to initiate prosthetic knee flexion
medial or lateral whip prosthetic causes
excessive rotation of the knee
tight socket fit
valgus in the prosthetic knee
improper alignment of toe break
medial or lateral whip amputee causes
improper training
weak hip rotators
knee instability
dysvascular
disease of the blood vessels
peripheral vascular disease, peripheral arterial disease, and complication related to diabetes
