Integumentary - Amputation Flashcards
(37 cards)
significant and relevance
60% of amp are funded by medicare/medicaid
limb salvage vs amputation
severity scores used by team to make decision
mangled, extremity, severity score, limb salvage index, nerve injury, ischemia, soft tissue injury, skeletal injury, shock and age of patient score (NISSA)
considerations
limb loss
boundaries of dead or diseased tissues
consider for prosthesis
mobility and function
cosmesis
myodesis
muscle secure to bone by sutured to distal tendon by holes
often in BK/AKA to help with deformities in resisdual limb
myoplasty
attaching sectioned muslces to opposing muscles
minor amputation
toe and partial foot ampulations
major amputation
proximal to tarsometatarsal jt
balance
at the ankle jt
reduced balance due to
- loss of somatosensory
- reduced WB
- reduced confidence
- ADL limits
- higher fall risk
balance at ankle jt
reliance on other balance strategies
LOS is reduced
lack of kinestic awareness to adjust to surface
partial foot amputation
transmetatarsal
- keeps ankle integrity
ankle disarticulation or syme’s
return to function of LLA
lower limp amputation
prosthetic device
standard shoe wear
gait characteristic LLA
loss of power generation
not enough evidence regarding intervention
BKA
or transtibial
20-50% tibial length is spared
preserves the knee
loss of muscle control of LLE
knee disarticulation
femur is intact
gait characterisitcs of BKA
decreased velocity
shorter step length
increased stance phase on unaffected limb
decreased stance on sound limb
asymmetrical stance phase duration
AKA
or transfemoral
35-60% femur length spared
hip joint is good
loss of jt below and impaired muscles below pelvis
energy use to walk goes higher 60-65%
gait characterisitics
AKA
lateral lean in stance
wider BOS
circumduction
abducted gait - laterally displaced
uneven step length
lordosis is exaggerated
UE amputation
- transradial
- elbow disarticulation
- transhumeral
- shoulder disarticulation
- wrist disarticulation
- partial hand, metacaroal and thumb phalangeal
age prevelence of UE amp
- > 80% are because of trauma
- ages 15-45 y.o
- cancer/tumor
- increased risk age 65+
goal of pre-op
assess body condition
pt education about limb
phantom pain and sensation
goal of acute post-op
wound healing
pain control
emotional support
strengthening
ROM maintenance
goal of pre-prosthetic
limb shaping
limb care
edema management
soft tissue mobility
adhesion prevention
desensitization
strength and ROM
core strengthening
balance
postural control
prosthetic training
increased static or dynamic use
increased wear time
short-medium-long term goal setting
indep donninng and doffing
care and maintenance
goal of community reintegration
regaining emotional equilibrium and healthy coping strats
pursuit of recreational activities
