Rehab after amputation Flashcards
what are the chances of amputation after an ulcer in pts w DM?
25% chance of amputation
if a child with PFFD is born with longitudinal fibular absence, what kind of surgical conversion is performed?
Syme’s (ankle disarticulation)
when is independent gait expected for children with PFFD?
15-22 mos
what amputation has the poorest healing rate?
partial foot (44-70%)
what factor, in addition to having a dx of DM, greatly increases a patient’s chance of amputation?
losing DF because incr P on met heads
where do you tend to see callouses in pts with DM?
2nd/3rd met
tissue is deemed “viable” if the ABI is..
> 0.9
what length of a TTA makes it SIGNIFICANTLY weaker?
<15.1 cm
the anterior incision line of an amputation should appear..
about 1 cm above bone end
which LE amputation has the highest rate of post-op mortality?
TFA (13.3%)
what type of dressing has the SLOWEST healing rate?
soft dressing; also gives INCONSISTENT P
if a pt has DM, what type of dressing is recommended?
semi-rigid (NOT RIGID – incr risk of infection
rigid dressings work particularly well with what type of amputations?
TFA (less bony prominences)
3 contraindications for using rigid dressing + IPOP
vascular disease, decr sensation, risk of infection ;
What dressings can you use a temporary prosthesis with?
rigid (IPOP) and Semi-Rigid
when can you put on a shrinker?
staples are removed, NOT if a large amt of edema present;
what can you do in an ACUTE CARE setting to prevent WBing of a wound?
DIY rocker bottom & avoid stand-pivot
trans-metatarsal amputees are at risk of — contractures
PFers
what are some examples of therex to use NOT IN ACUTE
CKC stump exercises: bridge on bolster, hip abd/add/hit ext; balance tx, arm bike, swimming, CKC PNF, other quadruped activities
IMMEDIATE post-op strengthening:
isometrics : glutes, quads, hamstrings;
AROM
UE exercises
when should you debride/mobilize a scar?
incision line ADHERENT scab & scar
if pt has EDEMA & PAIN, PoC is..
wear shrinker (ONLY if no staples!), limb dressing (SRD), or socket (during pre-prosthetic tx)
how much is energy expenditure increased during prosthetic gait?
about 4/3 as much energy to walk 2/3 as fast
CRITERIA for prosthetic fitting:
incision sufficiently healed: -adherent scab -min serosanguinous drainage stable girth: - conical (preferred) or cylindrical -NOT BULBOUS ambulatory on sound limb (or I in xfers if B)
