Amputations

Question 1

Why are amputations below the hip more advantageous?

Answer 1

Its easier to attach a prosthetic

Question 2

Review Slide with photo of Amputation locations

Answer 2

Review Slide with photo of Amputation locations

Question 3

Who is a candidate for an amputation?

Answer 3

• PAD/PVD (esp. older pt.’s with DM)
• Trauma
• Thermal injuries
• Osteomyelitis
• Tumors
• Congenital limb disorders

Question 4

Types of Amputations

Answer 4

Open (guillotine) Vs Closed

Elective Vs Traumatic

Question 5

Open Amputation

Answer 5

Clean cut (Not approximated)

• wound bed left open
• may need to drain or be cleaned (infection)

Question 6

Closed Amputation

Answer 6

Wound approximated

-no drainage

Question 7

Elective Amputation

Answer 7

Ex) PVD

-has time to grieve and anticipate procedure

Question 8

Traumatic

Answer 8

Ex) Motor vehicle crash

Question 9

Complications of Amputations

Answer 9

1. Hemorrhage
   - check VS, dressing, pooling
2. Infection
3. Phantom limb pain
   - Self limiting, may use “mirror therapy”
4. Flexion contractures (esp. at hip)

Question 10

Amputation: Post-OP Care + Patient Teaching

Answer 10

1. Assess tissue perfusion
2. Pain management
   - ATC dosing, phantom limb “mirror therapy”
3. Prevent infection
4. Promote proper positioning/ambulation/exercise
   - prone position 30 min 4x daily (forced to extend hip)
   - elevate stump/residual limb? provider preference
5. Initially: compression bandage (fosters shaping & molding of limb)
   - wear AAT except @ PT and bathing
   - figure-8 wrapping (prevent blood flow restriction)
6. Psychosocial Issues
   - many times devastating
7. Prosthesis: Certified prosthetist-orthotist

Question 11

What is? the purpose of Residual Limb Bandaging?

Answer 11

To ensure the limb is shaped and molded for eventual prosthesis fitting

Question 12

What else can be done to help fitting?

Answer 12

Compression, it promotes “limb shrinkage + maturation”

Question 13

How often should residual limb bandages be removed and reapplied?

Answer 13

Several times daily initially

Question 14

Common Amputation Terminology: Lower Limb

Answer 14

BKA: Below knee
AK: Above Knee
HD: Hip disarticulation
KD: Knee disarticulation
AD: Ankle disarticulation
PF: Partial foot (Chopart)
Syme's: Below ankle
Hemipelvectomy: At pelvis

View Slide

Question 15

Common Amputation Terminology: Upper Limb

Answer 15

BE: Below elbow
AE: Above elbow
Hand + Wrist: ......
Forequarter: Entire arm to neck
SD: Shoulder disarticulation
ED: Elbow disarticulation
PH: Partial hand 

View Slide