History & Surgery

Question 1

earliest sign of amputation was…

Answer 1

35-45000 years ago

Question 2

first written record of amputation was…

Answer 2

ancient mythology

Question 3

early amputation was mostly for ______

Answer 3

trauma
*eventually progressed to being used for ulcers, tumors, and congenital deformities

Question 4

what was used to control bleeding in early amputations

Answer 4

cauterization (in hot oil)

Question 5

who introduced ligatures and first described phantom limb syndrome

Answer 5

ambrois pare

Question 6

what led to improved skin flaps and ideal level of amputation

Answer 6

WW1

Question 7

what led to greater consideration of limb shaping and improving muscle function

Answer 7

WW2
*also when prostheses were introduced

Question 8

osteointegration

Answer 8

implanting a device into the bone

Question 9

development of prostheses were believed to begin about…

Answer 9

1500BCE

Question 10

5 general principles for amputation

Answer 10

1 - preserve as much length as possible
2 - provide a residual limb that can tolerate stress
3 - pull down nerves prior to resection to minimize neuromas
4 - sever muscles
5 - broad skin flaps shaped well

Question 11

myoplasty

Answer 11

suture muscle to muscle

Question 12

myodesis

Answer 12

anchor a muscle to the bone

Question 13

what skin flaps with transmetatarsal amputation

Answer 13

anterior and long posterior

Question 14

what is the most common amputation

Answer 14

transtibial

Question 15

what skin flaps with transtibial amputation

Answer 15

long posterior to preserve gastroc

Question 16

what skin flaps with transfemoral amputation

Answer 16

equal ant/post or long medial

Question 17

how is the femur stabilized in transfemoral amputation

Answer 17

adductors are wrapped around to prevent femur from being in an abducted position

Question 18

what is an osteomyoplastic reconstruction (Ertyl procedure)

Answer 18

a bone graft is taken from the distal end of the tibia and fibula and are sutured together in a tube-like fashion
*bone bridge that enables stump to bare weight

Question 19

with what amputations can an osteomyoplastic reconstruction be applied

Answer 19

transfemoral
transmetatarsal

Question 20

2 stage process of osteointegration

Answer 20

1 - limb amputated and implant placed
2 - later incision is opened and an externally protruding connector is placed
(1 stage process not approved in the US yet so we’re behind)

Question 21

what are the most common complications of osteointegration

Answer 21

infection and soft tissue irritation at the stoma