MT: Transfemoral Surgery & Post Op Care Flashcards
1
Q
Causes for TF amputations
A
- older
- more corborbidities
- majority vascular
* diabetes (10x more likely to have TF amp)
2
Q
When is mortality rate 100% higher in TF than TT
A
within the first 30 days
3
Q
Considerations and complications for TF amp
A
- Tf expend more energy
- longer limb = better suspension
- muscle atrophy
- more time sitting than TT
- femur can protrude
4
Q
Muscle atrophy in TF
A
- inversely proportional to limb length (shorter limb = more atrophy)
- hip extensors
- hip adductors
5
Q
Traditional TF Amputation
A
- No consideration of muscular imbalance
- no beveling of the femur
- shorter surgery decreases risks of complications
6
Q
Knee Disarticulation Pros
A
- longer lever arm
- more musculature preserved (adductor magnus)
- less energy expenditure
- some distal weight bearing
- self suspending
- no need for IC
7
Q
Knee Disarticulation Cons
A
- cosmesis
- bulbous
- knee centers do not match
- limited componentry
8
Q
Candidates for KD
A
- peds
- active individuals
9
Q
Peds KD
A
- disartics dont have issues with bony overgrowth
- preserves length/growth plates
- growth plates can be fused to allow TF length, with KD functionally
10
Q
Once the amputation is proximal to the femoral condyles:
A
- still no knee extensors
- still weakened hip extensors
- further weakened hip adductors
- lack of stabilization of femur in all planes
11
Q
What muscles are rarely impacted by TF amp
A
- hip flexors
- hip abductors
12
Q
What is always transected in TF amputation
A
Quads
13
Q
What anterior musculature is never transected
A
- Iliopsoas
- hip flexor strength unimpacted
14
Q
What medial musculature will always be transected
A
- adductor musculature
- amputation of distal 1/3 femure results in 70% loss of adductor strength
15
Q
How will loss of adductor strength impact the patients gait/control?
A
inability to stabilize femur in coronal plane