Q1: TT Surgery & Post Op Flashcards
1
Q
What is the ultimate goal of amputation
A
- save the live of the patient or provide a reconstructive option if the function
2
Q
Amputation Indications
A
- uncontrollable sepsis
- non-reconstructable dysvascular limb
- malignancy in which limb salvage is not an option
- chronic pain unresolved
- certain congenital deformitites
3
Q
What is MESS and what is it used for
A
Mangled Extremity Severity Score
Used for the decision to amputate
4
Q
What are the ideal limb lengths according to Ficke
A
- 12 cm distal to knee joint ( to preserve length and lever arm)
- 23 cm proximal to plantar heel pad (to allow selection of “optimal” prosthetic components)
5
Q
TRUE OR FALSE
When vascular compromise is present, amputation length will be determined primarily by available viable soft tissue
A
TRUE
6
Q
Traditional Treatment
Nerves
A
- traction neurotomy or “drawn down, divided, and allowed to retract
- leaving cut nerve ending has been suspected to increase the incidence of neuromas and nerve pain after amputation
7
Q
Regenerative Peripheral Nerve Interface
A
nerve endings are wrapped in muscle graft
8
Q
Targeted Muscle Reinnervation
A
nerve endings are attached to intact muscles
9
Q
Myodesis
A
achilles tendon and fascia of soleus are sewn to anterior tibia periosteum
10
Q
What is the Ertl Procedure
A
- osteomyoplastic technique
- bone bridge using periosteum
- originally: closed tibial medullary canal
11
Q
Ertl Advantages
A
- wider base for prosthetic fitting
- stabilization of distal tibia-fibula interval
- end bearing usually misnomer
12
Q
Ertl Disadvantages
A
- longer surigcal time
- leads to longer tourniquet time which can increase complications
13
Q
Ertl indications
A
- young healthy individuals
- fibular instability from trauma
- popular with elite athletes
14
Q
Post Operative Goals
A
- PROTECT residual limb to allow healing
- PRESERVE and or improve ROM and strength
- PREPARE the residual limb for prosthesis use
15
Q
Post Op management
A
- soft dressing
- rigid dressing (removable or non-removable)
- pre-fab post op prosthetic systems
