Amutations Flashcards
1
Q
Most common amputations?
A
- Lower amputatoins
- 80%-90%
2
Q
Causes of Amputation
A
- Peripheral Vascular Disease (Major)
- Diabetes, smoking,
- Trauma (Secondary)
3
Q
Levels of amputations
A
- Partial Toe
- Toe Disarticulation
- Partial Foot / Ray resection
- Transmetatarsal
- Symes - ankel disarticulation
- Below Knee (unilateral/bilateral)
ie: Long transtibial, Transtibial, Short transtibial - Knee Disarticulation
- Above knee
ie: Long Transfemoral, Transfemoral, Short Transfemoral - Hip disarticulation
- Hemipelvectomy
- Hemicorporectomy
4
Q
Partial Toe
A
- Excision of any part of one or more toes
5
Q
Toe Disarticulation
A
- at the MTP joint
6
Q
- Partial foot / ray resection
A
- 3rd, 4th, or 5th MT’s and digits
7
Q
Transmetatarsal
A
- amputation through the medsection of all MT’s
8
Q
Symes - Ankle Disarticulation
A
- Heel pad attached distally to the end of the tibia
9
Q
Advantage of the Symes
A
- can bear weight on residual limb without prosthesis
10
Q
Below knee Unilateral
A
- likely to become functional prosthetic users
11
Q
Below Knee Bilateral
A
- can become functional prosthetic users
12
Q
Below Knee Long Transtibial
A
- > 50% of Tibial Length
13
Q
Below Knee Transtibial
A
- 20%-50% of Tibial Length
14
Q
Below Knee Short Transtibial
A
- < 20% of Tibial Length
15
Q
Knee Disarticulation
A
- Femur intact
16
Q
Above Knee Unilateral
A
- Elderly unilateral more difficulty becoming functional prosthetic users
17
Q
Above Knee Bilateral
A
- most bilateral do not become functional prosthetic users
18
Q
Above Knee Long Transfemoral
A
- > 60% of Femoral Length
19
Q
Above Knee Transfemoral
A
- 35%-60% of Femoral Length
20
Q
Above Knee Short Transfemoral
A
- < 35% of Femoral Length
21
Q
Hip Disarticulatoin
A
- Pelvis intact
- Result of tumors or severe trauma
- small 1% of amputations
22
Q
Hemipelvectomy
A
- Lower 1/2 of pelvis
- results of tumors or sever trauma
- small % of amputations
23
Q
Hemicorporectomy
A
- Bilateral LE’s and Pelvis below L4-L5
- Result of tumors or severe trauma
- Small % of amputations
24
Q
Goals of Surgery
A
- Remove what needs to be removed
- Allow for wound healing
- Construct a residual limb for optimal prosthetic use
25
How should a optimal residual limb look and feel?
- At the lowest possible level of compatible with healing
- Scar needs to be pliable, painless, and non-adherent
- Bone ends are rounded and beveled
- Muscle ends are stabilized by suturing them together to other muscles fascia or bone
26
Bone Bridge
- Dr Ertl
| - Distal ends of the Tibia and Fibula for weight bearing
27
Oldest Method of Soft dressings
- Still commonly used
28
Elastic Wraps
- Soft Dressing
| - require frequent re-application
29
Shrinker
- Soft Dressing
- Can be used after the wound heals
- Must have a good distal contact
30
Advantages to Soft Dressing
- Inexpensive
- Light weight
- Can be removed / Laundered / easy access to incision
31
Disadvantages of Soft Dressing
- Poor edema control and poor protection
- Elastic wrap requires skill for proper application
- Needs frequent re-wrapping
32
Semi-Rigid Dressing
- Several Types
| - IPOP Immediate Post Op Prosthesis
33
Advantages to Semi Rigid Dressing
- IPOP (the best)
- Significantly better edema control
- Most can be removed to observe wound
- Allows early ambulation on plylon
- Very limited intial weight bearing
- Weight bearing alarm can be built into pylon
34
Disadvantages of Semi Rigid Dressing
- Relatively expensive
- Cannot be applied by the pt
- Some have no access to incision
35
Rigid Dressing
- Plaster or Fiberglass or plastic shell with attachment for pylon and foot
- Plaster dressings are not removable, other types my be removable
36
Advantages to Rigid Dressing
- Best Edema control and pain of residual limb control
- Allows early ambulation on pylon
- Very limited early weight bearing
- Allows early prosthetic fitting
37
Disadvantages of Rigid Dressing
- Expensive
- Requires skilled application
- Does no allow easy wound inspection
- Requires close supervision during wound healing
