Amutations Flashcards

1
Q

Most common amputations?

A
  • Lower amputatoins

- 80%-90%

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2
Q

Causes of Amputation

A
  • Peripheral Vascular Disease (Major)
  • Diabetes, smoking,
  • Trauma (Secondary)
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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
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4
Q

Partial Toe

A
  • Excision of any part of one or more toes
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5
Q

Toe Disarticulation

A
  • at the MTP joint
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6
Q
  • Partial foot / ray resection
A
  • 3rd, 4th, or 5th MT’s and digits
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7
Q

Transmetatarsal

A
  • amputation through the medsection of all MT’s
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8
Q

Symes - Ankle Disarticulation

A
  • Heel pad attached distally to the end of the tibia
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9
Q

Advantage of the Symes

A
  • can bear weight on residual limb without prosthesis
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10
Q

Below knee Unilateral

A
  • likely to become functional prosthetic users
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11
Q

Below Knee Bilateral

A
  • can become functional prosthetic users
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12
Q

Below Knee Long Transtibial

A
  • > 50% of Tibial Length
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13
Q

Below Knee Transtibial

A
  • 20%-50% of Tibial Length
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14
Q

Below Knee Short Transtibial

A
  • < 20% of Tibial Length
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15
Q

Knee Disarticulation

A
  • Femur intact
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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