What is myodesis? When is it used? Which amputation?
muscle to bone
to provide optimal stability
What is myoplasty? When is it used? Which amputation
muscle to muscle or soft tissue
in patients who are ischemic
What are the types of foot/ankle amputations?
Phalangeal removal Ray amputation Transmetatarsal amputation Lisfranc (tarsomet disarticulation) Chopart (disartic through midtarsal joint) Symes (ankle disartic)
What are the types of lower extremity amputations
BK (transtibial) Thru-Knee disarticulation AK (transfemoral) Hip disarticulation Hemipelvectomy Hemicorporectomy
What is the optimal tibia length in a BK?
5-7 inches (less than 3.5 inch is not feasible)
What is a rotationoplasty also called? When is it used?
Van Ness procedure
in cases of osteosarcoma and congenital lower-limb differences
What are the types of upper extremity amputation?
forequarter (with scapula) AE Elbow disartic BE Krukenberg (separation of radius and ulna) Finger
What is the timeline for an amputation?
0-2 wks pre-prosthetic training
0-4 wks post operative protector
4-6 wks sutures removed
6-10 wks incision healed, cast for prosthesis
6 wks-4mos temporary prosthesis and gait training
4 mos-8 mos therapy and adjustment
8 mos - 1.5 yrs receive permanent prosthesis
What are the primary post-operative care goals (6)?
Reduce edema and promote healing Prevent contractures Increase UE and LE strength Increase mobility and self-care Promote sound limb care Assist with limb loss adjustment
What kinds of contractures should be avoided?
How can they be avoided?
hip and knee flexion
use stump board in wheelchair, lay prone, support in straight elevated position
What are the 5 stages of loss?
Denial Anger Bargaining Depression Acceptance
What is nonpainful sensation or awareness experienced that gives form to a body part with specific dimensions, weight, etc.
What types of sensations do phantom sensations encompass?
Kinesthetic, kinetic, extroceptive
What are kinesthetic sensations?
posture, length, volume
What are kinetic sensations?
What are extroceptive sensations?
touch, temperature, pressure
What is a painful sensation experience w/in the limb that is no longer part of the body?
What is pain arising in the residual limb from a specific anatomical structure that can be identified?
residual limb pain
What does functional level 0 entail?
no ability or potential for weight bearing or transfer
What does functional level 1 entail?
ability or potential to transfer and ambulate in household with an AD
What does functional level 2 entail?
community ambulator with ability or potential to traverse minor environmental barriers w/ a fixed cadence
What does functional level 3 entail?
community ambulator w/ ability or potential to traverse all environmental barriers w/ a variable cadence
What does functional level 4 entail?
ability or potential for prosthetic ambulation that exceeds basic skills, exhibiting high impact stress, or energy levels