Week 1 Flashcards
How many amputees are major UE amputees?
41,000
What is the total number of UE amputees excluding fingers?
1,400,000
What percent of amputations are upper extremity amputations?
2.9%
What percent of UE amputations are hand amputations?
15%
What percent of UE amputations are wrist disarticulation amputations?
10%
What percent of UE amputations are trans-radial amputations?
31%
What percent of UE amputations are elbow disarticulations?
7%
What percent of UE amputations are trans-humeral amputations?
28%
What percent of UE amputations are shoulder disarticulations?
7%
What percent of UE amputations are forequarter amputations?
2%
What percent of UE amputations are congenital?
60%
What percent of UE amputations are due to cancer?
24%
What percent of UE amputations are due to trauma?
70%
What percent of UE amputations are dysvascular?
2%
What occurred in history to children with congenital abnormalities?
Infants were disposed of because they thought it was an act of vengeance by the gods upon the parent.
Till what date did amputations occur only as a last result for gangrene?
Till 100 A.D.
Who used the amputation procedure around 100A.D.?
Archigenes and Heliodorus used it for ulcers, tumors, injuries, and deformities. They used circumferential compression above the operative site on the healthy tissue.
What occurred in the 14th century to increase the amount of amputations?
The development of gunpowder.
When was the first recorded use of a tourniquet for hemorrhage control?
1674 by French army surgeon Etienne Morel
Who developed a tourniquet device to stop bleeding during amputation?
Jean Louis Petit in 1718
What made a surgeon good in the 17th century?
Speedy amputations for anesthetized patients
What are the four types of current amputation closures?
Myofascial closure
Myoplasty
Myodesis
Tenodesis
What is myofascial closure?
Encases the bone and transected muscle by closing the fascial envelope over the top of the muscle. Does not stabilize the muscle due to lack of distal attachment.
What is myoplasty?
Surgeon positions muscle over the distal end of the bone and attaches to the opposing muscle. Muscle can shift and cause pain on distal end.
What is myodesis?
Individual muscle groups are directly attached to the periosteum of the bone.
What is tenodesis?
Firm distal attachment of the severed tendon to the bone. Often not anatomically possible- only possible when the muscle belly is not transected and the tendon is intact.
Which is the least stable amputation technique?
Myofascial closure
Which is the most stable amputation technique?
Tenodesis
What are the three categories for prehension?
Precision
Power
Coal hammer
What are the six types of prehension?
Tip Cylindrical Lateral Palmer Hook Spherical
When is the krukenberg procedure performed?
On bilateral amputees
Blind
3rd world countries
What are the advantages of a wrist disarticulation?
Patient maintains pronation and supination
More pressure can be tolerated on distal aspect of limb
What is the disadvantage of a wrist disarticulation?
Wrist unit and hand length are more difficult to match contralateral limb.
What are the advantages of a longer trans-radial amputation?
More control over prosthetic
More area to decrease pressure on the limb
What are the advantages of an elbow disarticulation?
Trimlines can be shorter on the socket.
Epicondyles can be utilized for suspension.
What type of system can be used for a transhumeral amputation?
Duel cable system (fair-lead cable system)
Different movements allow for elbow flexion and extension others for opening and closing the terminal device
More maintenance is required
What type of device can be used by a bilateral shoulder disarticulation amputee?
A nudge control device- patient nudges control with their chin which allows the elbow to lock or unlock.
What are the disadvantages of a forequarter amputation?
Loss of balance
Prosthetic use is more difficult due to loss of muscle and proximal arm for control
Lower compliance/use rate
What distinguishes an acquired amputation compared to a congenital?
It’s a result of trauma or cancer
Adjustment process is crucial for family and child
What distinguishes a congenital amputee compared to a acquired?
Results from ABS or idiopathic in origin
No amputation, so the prosthetic is viewed as an aid
Higher chance of rejection of prosthesis.
What are the three etiologies of congenital patients?
Amniotic Band Syndrome
Longitudinal Deficiency
Transverse Deficiency
What are considered mild complications of amniotic band syndrome?
syndactyly
amputations of fingers or toes
What are considered severe complications of amniotic band syndrome?
clubbed feet
limb amputations
What does ISO represent?
International organization for standard
What is longitudinal deficiency?
Absence extending parallel with the long axis of the limb, either pre-axial, postaxial or central in nature.
What is Transverse deficiency?
The limb has developed normally to a particular level beyond which no skeletal elements exist
Who created another method for recording deficiencies?
Day created the Day Method when working with ISP.
