intro to amp Flashcards
are UE amp regular
no they make up a very small percentage
percent of above the knee amp
31%
percent of below the knee amp
47%
what two locations make up the greatest precentage of amp
above and below the knee
how do we decide where to amp
blood flow
extent of tissue necrosis
lines of demaration - gangrene
location of the tumor, cog deformity
in the UE do we expect the circulation to be impaired
no this is rare
why do we need to know about blood flow with amp location
there has to be enough blood flow to allow the are to heal
what is the line of demarcation in gangrene
the line the seperates healthy tissue and necrosis tissue
what are signs that we look for when we are deciding where to amp
palpable pulse in the major art above the amp site
above the knee pulse
femoral
belwo the knee pulse
popliteal
what does lisfranc mean
a collection of the bone and the ligament in the midfoot region
what is a lisfranc disarticulation/dislocations
a spectrum of injuries involving the tarsometatarsal joints of the foot.
lisfranc amp advantages
still are keeping the remainder of your foot, heel
lisfranc amp disadvantages
you are walking on parts of the foot that you are not supposed be walking on
what is a syme amp
ankle disarticulation - moves the calcaneus
remove of malleio
and anchoring heel pad to weight bearing surface
what is the LE amp of choice
trans tibial - having a knee is very beneficial
The outcomes for transfemoral are much worse then transtibial
why is the trans tibial the LE amp of choice
better able to tolerated post op fitting of. prothesis or ridgid dressing
what is the advantage of the long posterior flap tech
allows for better circulation, healing, fitting of pro
how does the length of the residual limb effect outcomes
affects mobility
short trans tibial outcomes
small moment arm and hard knee ext
standard trans tibial outcomes
biomech sufficient moment arm
long trans tibial outcomes
less padding
and potentially less blood supply
what is the mortality rate for trans tibial surgery
9.5%
posterior flap trans tibial fibula and tibia length
the fibular a is a little shorter then the tibia
posterior flap trans tibial front of the tibia
the front is beveled
posterior flap trans tibial - what is used as padding
long skin and muscle flap
gastroc
posterior flap trans tibial - where is the scar located
on the anterior border - there is less weight bearing in this location
what is the most popular type of trnas tib amp now adays
posterior flap
before there was a lot of weight bearing directly onto the bone
complications withe posterior flap tib amp, or just amp in general
delayed healing
infections
dehiscence
poor contour of the resisdual limb - dog ear or bulbous
neuroma
phantom pain
joint contracture
what does dehiscence mean
the splitting of the wound
what does Dog ears mean in terms of amp
characteristic puckering of the skin that can occur after surgical wound closure
they are preventable
what is a neuroma
benign tumor of nerve tissue that is often associated with pain or specific types of various other symptoms
what type of amp is performed more - trans tib or femoral
trans tib is performed more
what are some major indications for transfemoral
vascular disease
trauma
tumors
who has better functional outcome tib or femoral
tib
who has worst survival rate - tib or femoral
femoral (looking years after the surgery)
what posterior muscle is brought around to the front in femoral
adductor Magnus and attached to the lateral distal aspect
quad and hamstrings are sutured together
what does adductor myodesis prevent
the lateral movement of the femur
what is a lisfranc new term
partal foot
what is syme new term
ankle disarticulation
