Professional Documents
Culture Documents
ETIOLOGY
What are the causes of amputation?
1st year of life
Congenital deficiencies
1 to 10 years of age.
Motor vehicular accidents, tumor and trauma.
10 to 20 years of age
Malignancy is the most common cause.
55 years of age
Peripheral vascular disease
Congenital Amputations
Causes:
Intrauterine development
Hereditary
Teratogenic agents
Maternal diabetes
Amelia
Complete absence of the entire upper extremity or lower
extremity.
Hemimelia or Meromelia
Partial limb absence
Acheiria
Terminal transverse hemimelia, wrist level
Adactylia
Absent digit
Apodia
Absent foot
Phocomelia
Transverse total humeral radial , ulnar deficiency
Terminal
Complete loss of the distal end of an
extremity
Intercalary
Absence of intermediate parts with preserved
proximal and distal component of the limb.
Transverse/Horizontal
Absence of all skeletal elements distal to the
deficiency along a designed transverse axis.
Stump Length
Ischial tuberosity or the greater
trochanter to end of stump.
Below knee
Stump Length
From medial tibial plateau to end of
Normal Length
From medial tibial plateau to medial
malleolus
bone
What is a hip
disarticulation?
What is a transpelvic
amputation?
What is a Syme
Amputation?
Preoperative
Evaluation and Assessment
Emotional Counseling
Therapy Counseling
Operative Management
The cardinal rule is to preserve as much as
length as possible.
Avoid the following level:
Hindfoot
Distal 1/3 of the leg
Supracondylar of femur
Skin closure
Above knee amputee-fish mouth or middle
flap.
Below knee amputee-posterior flap/anterior
suture.
Post-Operative Management
Healing of wounds
Pain control
Preparation for prosthetic fitting
Shoulder depressors
Shoulder adductors
Flexor, extensor and abductor of the arm
Extensor of the forearm at the elbow.
Wrist extensor
Finger and thumb flexors
Post-Operative Dressing
Rigid
Made of Plaster of Paris
Change every 5-10 days.
Advantages
Limits post-operative edema
Allows for early ambulation
Reduces length of time for shrinking
Disadvantages
Requires careful application
Requires close supervision
Does not allow early wound inspection
Semi-Rigid
The Unna Paste Dressing
A compound of zinc oxide, gelatin, glycerin
and calamine maybe applied in the operating
room.
Advantage
Better control of edema
Disadvantage
May loosen easily
Soft Dressing
Oldest method of post-surgical management
of residual limb.
Advantage
Inexpensive
Lightweight and readily available
Easily laundered
Disadvantage
Weightshifting
Progressive ambulation between parallel bars
WalkeUneven terrain-stairs-ramps-curbs
Falling and getting-up
Transfer activities.
r-crutches-cane-unassisted on flat surfaces.
Single BKA
Double BKA
Single AKA
Double AKA
Single AKA and BKA
Unilateral hemipelvectomy
with prosthesis
Crutch ambulation without
prosthesis
Wheelchair
9-28%
41-100%
40-65%
150%
75%
125%
50%
9%
Class 5
Cosmetic Plus
The amputee is better off without a prosthesis
Class 6
Not feasible. Only a wheelchair is prescribed.
THE END