PT Management of Amputations Throughout the Continuum Flashcards
what is the primary cause of amputation?
PVD (peripheral vascular disease) of the LE particularly due to DM
what is the second leading cause of amputation?
trauma (MVA, machines, gunshots)
t/f: adults with DM are 10x more likely to have an amputation that someone without DM
true
PVD is most prevalent in what people?
males
those over 75 yo
African Americans
many amputations are preceded by what?
foot ulcers
are amputations more common in the UEs or LEs?
LEs
what are the levels of amputation in the LEs?
hemipelvectomy
hip disarticulation
transfemoral
knee disarticulation
trans tibial
ankle disarticulation
Syme’s (type of foot amp)
partial foot (CHopart, Lisfranc, transmatatarsal)
what are the levels of UE amputations?
forequarter
shoulder disarticulation
transhumeral
elbow disarticulation
transradial
wrist/hand disarticulation
partial hand (transcarpal/transmetacarpal)
t/f: in post-traumatic amputation, the surgeon will attempt to maintain the greatest bone length and save all possible joints
true
why is it important that surgeons try to maintain as much of the limb as possible?
bc have a greater limb length will decrease the metabolic cost of ambulation and lead to greater fxnal px
t/f: amputation d/t vascular disease is generally performed partial foot (transmetatarsal), transtibial, transfemoral
true
what are the types of skin flaps that may be used in amputation?
equal length flaps
posterior flaps
what type of skin flap involves a scar right on the distal tip of the residual limb?
equal length flaps
what type of skin flap involved taking the skin from the posterior aspect of the limb and wrapping is around so we see the incision on the anterior aspect of the residual limb surface?
posterior flaps
why are posterior flaps preferred to equal length flaps in amputation?
bc the posterior aspect of limbs often have better blood circulation to the area which promotes good healing
t/f: skin flaps in amputation are intended to be as BROAD as possible
true
scars should be…
pliable, painless, and non-adherent
what is the incision?
where the two ends of skin come together
what is the residual limb?
what’s left of the limb after the amputation
what things must we consider about the residual limb?
length
uncomplicated wound healing
creation of a pain-free limb
swelling of the residual limb
why is it important to understand where muscles were stabilized in an amputation?
bc it contributes to muscle fxn and resting postures
why must we stabilize major muscles that are cut during surgery?
to promote max muscle tension and fxn
how is muscle stabilization achieved post amputation?
myofascial closure (ms to fascia)
myoplasty (ms to ms closure)
myodesis/tenodesis
what are neuromas?
collections of nerve cell endings