UE Amputations Flashcards
What is the etiology of UE amputations as compared to LE ones?
90% due to trauma
10% PVD, tumor, infection, congenital
Soldiers
M btw ages 20-40
(much younger pt. population)
UE- more noticeable, more cosmetic, used for expression
What are the surgical issues that impact the functional outcome (good outcome) of a prosthetic
optimal skin closure and healing- will try to restore blood flow and save limb 1st
Contour of residual ms bellies
prevent neuroma
adequate vascular supply- critical, healthy
rounded distal edges- need cone shape residual shape in order to fit for prosthetic down the arm. Need enough coverage over bone
preserve joint ROM- limb length
Pre-prosthetic management
wound healing- early on, no infection, healing properly
pain management- acute, pain meds, coping
(acute trauma- sensory integration, control over therapy session (know the tx process), deep pressure (through dressings), do it themselves (in order to tolerate prosthetic), transfers, soft to more course sensations.
edema control- so can wear temp. prosthetic
skin care and desensitization- scar massage, roller, thumb massage, teach family
stump shaping- shrinker socks, donning/doffing, get limb shaped properly for prosthesis
ROM- key* sh., scap (use theraband loop)
Strength- theraband
psychological adjustment- increase, non compliance
education re: prosthetic choices
-fitted for temp prosthetic as soon as possible/right after healing process.
Early prosthetic management
Prosthesis within 1st 30 days of amputation have greater acceptance of prosthesis than those fit after 30 days.
What are benefits of body -powered prosthetic devices?
Advantages of UE Prosthetics
- body image
- provides non-dominant hand
- enhances bimanual activities
- accelerates function
- indep if loss of other limb occurs
What are drawbacks of body -powered prosthetic devices?
Disadvantages of UE prosthetics
- sensory feedback and movement can be impeded
- comfort can be compromised - need feed back
- skin reaction- allergic?
- frequent visits to prosthetist & OT- follow ups
What are common areas of OT eval & Tx for pre & post prosthetic training? Compare/contrast the two
OT role-
- deep pressure & desensitization right away!
- ROM
- ADL assessments
- strengthening
- adapt/modify as needed
Myoelectric Components
sensors on flexors and extensors of the hand/arm.
need to maintain range to activate device
take off during any water/moisture exposure
work on common acts
Hook
Hosmer Dorrance Corporation
voluntary opening’
voluntary closing
more accurate
can bend for wrist flexion and extension
can also be rotated for supination/pronation
Phantom Sensation
perception of presence of amputated limb
common in traumatic amputations- feel limb being in position they were in during accident
can be life long
intact neural system in brain even with absence of limb
(have perception of their fingers and hands)
mirror box therapy- visual perception- fools they brain that the body is whole again
What are common AE devices that might be coupled with prosthetics (do your reading!!)
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phantom limb pain
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