WK6- Amputation Surgeries Flashcards
Define residual limb pain.
pain in residual limb-stabbing, throbbing, pins and needles, hypersensitivity around and on incision area
managed my gentle massage/tapping
desensitization
TENS, modalities
positioning
assess post op dressing compression
Describe phantom sensation.
happens in 80% of post amp patients, tingling, numbness, itching, pressure
Describe phantom pain
shooting pain, severe cramping, or burning
Describe, briefly the physiology of phantom pain.
Due to cortical region reorganization, somatotropic representations border that of the missing limb
What are some effective strategies for treatment of phantom pain
mirror box therapy, VR, mental imagery
Describe the ideal residual limb post op.
cylindrical shape, length, muscle power, full range joint, well healed, mobile scar tissue, infection free, muscles covering bones, neuroma free
Give some examples of rigid post op residual limb dressings.
Immediate postoperative prosthesis (IPOP), rigid removable dressing (RRD)
Give examples of semirigid and soft post op residual limb dressings.
Semirigid: air splints, casts, protectors
soft: ace, shrinker ( liner )
When wrapping with an ace wrap what are some key considerations.
try to create cylindrical shape, create more compression distally as compared to proximally, avoid “choking” effect, have patient demonstrate back to you
What are some general key principles of amputation surgery ?
save as much length as possible, adequate circulation, preserve as many joints as possible, provide residual limb that can tolerate prosthetic stresses
What are the different levels of amputations from least amount of length to most ?
Transpelvic, Hip disarticulation, Transfemoral, Knee Disarticulation, transtibial, ankle disarticulation ( Syme’s), Transmetatarsal ( Chopart ), Lisfranc, Metatarsal, toe disarticulation or amputation
Compare and contrast myoplasty versus myodesis.
myoplasty: muscle is attached to muscle often antagonist in TF patients
myodesis: muscle is attached to bone directly
Describe the following amputation: Lisfranc amputation
tarsometatarsal disartic.
Describe the following amputation: Chopart
midtarsal disartic.
Describe the following amputation: Syme’s
ankle disarticulation, talocrural joint