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PRM Board Exam > Limb Deficiencies > Flashcards

Limb Deficiencies Flashcards

1
Q

When during gestation do limb deficiencies occur?

A

during formation of the limb from day 26 to 8 weeks

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2
Q

What are three medications linked to congenital limb deficiency?

A

thalidomide, retinoid acid, and misoprostol

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3
Q

What is the preferred classification system for congenital limb deficiencies?

A

ISPO (International Society for Prosthetics and Orthotics)

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4
Q

What is a transverse deficiency?

A

Deficiency with no distal remaining portions

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5
Q

What is a longitudinal deficiency?

A

Deficiency with distal remaining portions

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6
Q

How are longitudinal deficiencies named?

A

They are named for the bones that are affected. Any bone not named is present and of normal form.

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7
Q

How are transverse deficiencies named?

A

It is named after the segment beyond which there is no skeletal portion

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8
Q

What is acheiria?

A

missing hand or foot

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9
Q

What is adactyly?

A

absent metacarpal or metatarsal

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10
Q

What is amelia?

A

absence of a limb

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11
Q

What is hemimelia?

A

presence of half a limb

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12
Q

What is phocomelia?

A

“seal limb”: hypoplastic proximal limb with near normal hand or foot

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13
Q

What is meromelia?

A

partial absence of a limb

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14
Q

What other anomalies are associated with limb deficiencies?

A

craniofacial

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15
Q

What is the most common congenital limb deficiency?

A

left terminal transradial

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16
Q

When should fitting for a unilateral upper limb deficiency take place?

A

When a child achieves sitting balance

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17
Q

When should a child transition from a passive upper limb prosthesis to one that can grasp and release?

A

When the child begins to walk and has an attention span > 5 minutes

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18
Q

What is the Krukenberg procedure?

A

creation of a prehensile surface for children with absent hands by separating the radius and ulna

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19
Q

Which gross motor activity is more difficult with a transhumeral prosthesis than with a transradial?

A

rolling over

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20
Q

At what age range can a child use a body-powered hook?

A

2 - 3

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21
Q

At what age range can a child use a body-powered elbow?

A

4 - 5

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22
Q

What is the Vilkke procedure?

A

attaching a toe to the residual limb to create a pincer grasp

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23
Q

What is the most common lower limb deficiency?

A

fibular longitudinal deficiency (fibular hemimelia)

24
Q

How often is fibular longitudinal deficiency bilateral?

A

25% of the time

25
Q

What is the treatment of choice for a tibial deficiency?

A

knee disarticulation

26
Q

What is PFFD

A

proximal focal femoral deficiency where the femur is short and held in flexion, abduction, and external rotation

27
Q

What other deficiency is commonly associated with PFFD?

A

fibular deficiency (70 - 80% of the time)

28
Q

What is the typical treatment for PFFD?

A

Fusion on the femur and tibia to allow acceptance of an above-knee prosthesis

29
Q

When is a child with a lower-limb deficiency fit with a prosthesis?

A

When they are ready to pull to stand (9-10 months)

30
Q

When does the normal child establish a heel-toe gait pattern?j

A

2 years old

31
Q

When is a knee joint added to a child’s prosthetic lower limb?

A

18 months

32
Q

What is the most common prosthetic foot given to children?

A

SACH

33
Q

When is a polycentric knee a good choice?

A

long residual limb with difficult to match knee centers

34
Q

About how often are prosthetic limbs replaced between 5 to 12 years old?

A

about every 2 years

35
Q

What is the most common cause of pediatric acquired amputation?

A

trauma (MVC, train)

36
Q

What is the most common cause of disease related amputation in children?

A

tumors (osteogenic and Ewing’s sarcoma)

37
Q

Why is it important to retain the bony growth centers when performing a pediatric limb amputation?

A

To allow for continued growth and prevent distal bony overgrowth

38
Q

What is the most common complication after amputation in a child?

A

terminal overgrowth

39
Q

What is the most common site for terminal overgrowth after amputation?

A

humerus (terminal overgrowth is not funny)

40
Q

What are predictors of ability to use power mobility in a child?

A

cognitive skills of spatial relationships and problem solving

41
Q

What has been associated with increased likelihood of developing phantom pain after an acquired amputation in a child?

A

Older age, particularly over age 10

42
Q

What are two maternal factors linked to congenital limb deficiencies?

A

cigarette smoking and poorly controlled diabetes

43
Q

What are two advantages of the Van Nes rotationplasty?

A

proprioceptive control of the knee and ability to use reciprocating gait when climbing stairs

44
Q

What type of amputation is preferred in pediatrics?

A

through joint

45
Q

What can be done to prevent terminal overgrowth in a child if a through joint amputation is not possible?

A

stump capping

46
Q

What is the most common long bone deficiency?

A

longitudinal fibular deficiency

47
Q

What dictates surgical planning in fibular deficiency?

A

stability of the ankle and foot

48
Q

How many rays are needed for ankle and foot stability in a fibular deficiency?

A

3 or more

49
Q

When are foot ablation procedures preformed in a child with fibular deficiency who is a candidate?

A

when pulling to stand

50
Q

What are the surgical options in a child with a fibular deficiency and unstable ankle?

A

Syme and Boyd amputations

51
Q

What are the advantages of a Boyd amputation over a Syme?

A

heel pad stabilization, improved prosthetic suspension and weight bearing through distal end

52
Q

What is the disadvantage of a Boyd compared to a Syme?

A

longer time until prosthetic fitting (6-8 weeks)

53
Q

Deficiency of what bones warrant a genetic work-up?

A

radius and tibia

54
Q

When can the knee be preserved in a patient with a tibial deficiency?

A

When there is active quadriceps function

55
Q

What is the most common congenital limb deficiency that results in prosthetic or surgical complications?

A

PFFD

56
Q

What dictates surgical treatment options in PFFD?

A

femoral length and stability of lower extremity joints

57
Q

What are two treatments for phantom limb pain?

A

gabapentin and mirror therapy

PRM Board Exam (17 decks)

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