Amputation Flashcards

Question

disadvantages of bandaging /shrinker socks

Answer 1

may slip off, loosen easily slower healing, longer hospital stay elastic bandage can be inconsistent with application causing pressure problems shearing over wound with shrinkers

Answer 2

check stump first, dressing over wound all bandages turns should be diagonal (not spiral) to avoid tourniquet (figure 8 dressing) Never restrict blood flow - pain = reduced circulation should be applied with extended knee graduated pressure, firm at the end of stump, apply pressure on upwards turn. should be able to fit finger under top re-apply ever 4h no folds, creases, windows no pins to secure, use only tape worn 24/7

Answer 3

should be tight but not painful or restrict blood flow make sure the top does not roll - can reduce blood supply when starting to use a prosthesis the shrinker should be worn whenever the prothesis is off seam should not shear over wound

Answer 4

tissue tightening resulting in pain and reduced ROM | Amputees are at risk of flex/ext contractures at the hip

Answer 5

``` no pillows under stump or thigh no crossing legs in bed maintain knee extension (stump board) in sitting prone lying to maintain hip extension early ambulation/standing active strengthening/AROM -hip extension -knee extension RRD ```

Answer 6

``` prone lying maintain joint ROM increase muscle strength - reduce LL atrophy as a result of poor positioning/reduced use of muscles -don't forget the intact limb -remember the upper limb ``` balance retraining- transfers increase CV endurance - self propelling in wheelchair and/or walking with prosthesis

Answer 7

``` key to independence reduces complications of bed rest practice bed mobility transfer practice - pivot practice -stand transfer -slide board (also helps to protect stump) STS transfer onto frame Floor to chair transfer - in case of fall ```

Answer 8

hopper two single sticks one single stick crutches

Answer 9

stable but slow and does not allow step through gait

Answer 10

less stable but allows step through gait and reciprocal gait pattern

Answer 11

enables good balance but need even WB and requires increased strength and balance

Answer 12

encourage stooping and does not allow effective use of glutes (major stability muscles when walking)

Answer 13

pneumatic post amputation mobility aid -used for transtibial and transfemoral amputees aluminium support frame with air bags to hold limb PWB aid only used primarily in parallel bars

Answer 14

use >7days post op (depends on wound healing) can be applied over stump dressings, shrinkers etx air bags cup around stump - 40mmHg for mobilising worn for 5-10 minutes initially - stump must be examined gradually build up wearing time

Answer 15

``` psychological boost patient is upright and weight bearing provides total stump contact aids in oedema reduction can give indication about whether suitable for prosthesis Can be re-used for other amputees ``` but - no natural knee movement used gait tricks -- circumduction -time consuming set up

Answer 16

``` good stump condition adequate ROM and strength Able to hop no medical issues preventing training intact cognitive function - ability to learn complicated task of gait retraining and safety in using a prosthesis medical issues affecting cognitive function eg. dementia, stroke may limit ability social situation attitude and motivation ```

Answer 17

TTA requires 40% more energy to walk with a prosthesis than walking with two legs TFA requires 100% more energy to walk again can preserve energy by slowing down when walking and /or using a walking aid

Answer 18

PWB as soon as surgeon allows (PPAM aid/interim) FWB as soon as wound is healed with no open lesions which varies from 14 days to months compression therapy is extremely important - stump volume decreases rapidly in first 3 months, then gradually over next 15 months refer to QALS

Answer 19

once the wound is healed (at least 8/52) post op allow modifications to be made in the learning phase and while the stump stabilises in size

Answer 20

fitted once learning phase is completed finished to look like the intact leg usually provides 3 years of use to an amputee before replacement