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Prosthetics overview Flashcards

(53 cards)

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1
Q

What causes most amputations in the US?

A

disease causes 82%

  • peripheral vascular disease
  • diabetes
  • infections
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2
Q

T/F: Over half of diabetics with LE amputations will require amputation of the second leg within 2-3 years.

A

True :(

55% require amputation of the second leg

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3
Q

What race is up to 4 times more likely to have an amputation than white americans?

A

African americans

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4
Q

Causes of peripheral vascular disease (PVD) include…

A 
arteriosclerosis (occlusive artery disease)
embolism
thrombosis
trauma
infection
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5
Q

Insufficient blood flow d/t decreased arterial diameter is known as…

A

intermittent claudication

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6
Q

This disease causes 82% of disease related amputations

A

PVD

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7
Q

Decreased return of venous blood from the legs to the trunk is known as…

A

chronic venous insufficiency

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8
Q

Signs of chronic venous insufficiency

A

Edema, dilated veins and stasis ulcers, dermatitis.

“weepy wounds,” ulcers above the maleoli

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9
Q

Early signs of chronic venous insufficiency (CVI) include

A

varicose veins -> swollen leg -> purplish reddish staining of the skin -> ulcers

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10
Q

Half of PVD amputations are due to this disease

A

diabetes

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11
Q

When a patient comes to you with an amputation and diabetes, ask them about these comorbidities…

A

renal failure (ask about urination)
cardiac disease
stroke
retinopathy (ask how their vision is)

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12
Q

Signs of diabetic neuropathy

A

decreased temp in feet
stocking glove sensory loss
decreased DTRs
dry scaly skin d/t decreased circulation
skin breakdown
intrinsic weakness, structural changes in the foot (Charcot)

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13
Q

This type of bone tumor is found in males 10-25, often in the metaphysis of long bones

A

osteosarcoma

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14
Q

This type of bone tumor is found in 5-30 year old males, the bone cortex erodes and a mass is produced

A

Ewing’s sarcoma

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15
Q

This congenital birth defect has

no distal structure

A

transverse

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16
Q

This congenital birth defect has

total or partial absence with normal skeletal structure beyond

A

longitudinal

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17
Q

This congenital birth defect is an

absence of the whole limb

A

amelia

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18
Q

This congenital birth defect is an

absence of hand or foot

A

apodia

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19
Q

This congenital birth defect is an

absence of limb segment, flipper limb

A

phocomelia

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20
Q

What is the goal of surgical amputations?

A

preserve as much of the functional healthy limb as possible

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21
Q

What is a neuroma?

A

painful collection of nerve axons near the skin, can be palpated and is very sensitive!

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22
Q

Amputation procedures:

Attachment of muscle to muscle

23
Q

Amputation procedures:

attachment of muscle to fascia

Study These Flashcards
A

myofascial flap

24
Q

Amputation procedures:

attachment of muscle to periosteal bone

25
T/F: a typical transtibial amputation includes myoplasty, myofascial flap, AND myodesis
True. Typical amputation includes all 3.
26
What type of flap is preferred on a transtibial amputation?
long posterior flap, provides a good weight bearing surface
27
In severe dysvascular situations, medial and lateral tissue is used to create this type of flap
skew flap
28
What type of flap is used when conserving bone length or vascular issues is not a concern?
equal length flap
29
What is the ideal shape of a residual limb?
cylindrical
30
Where is the transfemoral amputation ideally performed?
4" or 10 cm above anatomical end of knee
31
An autograft from the proximal tibia or iliac crest which creates a BRIDGE between distal tibia and fibula is called...
ERTL procedure
32
What is the goal of an ERTL procedure?
prevents separation of fibula from tibia permits greater end bearing
33
What is the advantage of a rotationplasty?
- preserves the ankle joint to act as a knee joint | - provides a longer lever for prosthetic control vs a very short AKA
34
What are advantages of osseointegration?
Lighter No socket greater motion more precise control
35
What are disadvantages to osseointegration?
2 surgeries | high risk of infection
36
What is osseointegration?
- More prevalent in Europe | - direct skeletal attachment of prosthetic limb
37
What are some problems with short transfemoral amputations?
more skin breakdown | hard to get enough hip extension since there's less leverage
38
Levels of amputation:: | hemipelvectomy
loss of Ilium, ischium or pubis
39
Levels of amputation:: hip disarticulation
loss of entire femur
40
Levels of amputation: Transfemoral classifications
short <35 % of femur medium 35-60% long >60%
41
Levels of amputation:: | supracondylar
patella left for better end bearing | may delay healing
42
Would you recommend a knee disarticulation to an adult patient?
No! Results in abnormal gait, difficulty with swing phase.
43
Why would a knee disarticulation be performed?
To maintain femoral length in growing children
44
Levels of amputation:: | Transtibial classifications
very short <20% tibial length present standard 20-50% long >50%
45
What level of transtibial amputation is typically best?
Standard! if very short, short lever arm and knee ext difficult if long there may not be adequate circulation
46
What is a syme amputation?
ankle disarticulation | tibia and fibula shaved, and a thin layer of the calcaneus is fixed to the distal tibia
47
Advantages of a syme amputation
long lever arm | ability to ambulate without a prosthesis
48
Disadvantages of a syme amputation
neuroma of posterior tibial nerve poor cosmesis unstable heel flap
49
What is a Lisfranc disarticulation?
- disarticulation of all five metatarsals and digits | - performed at tarsometatarsal joint
50
What is a Chopart disarticulation?
- through the midtarsal joint, leaves the calcaneus and talus - performed at the talonavicular and calcaneocuboid joints
51
Why are Chopart and Lisfranc disarticulations not performed as often today?
They lead to equinovarus deformity | and skin breakdown! Important to stress dorsiflexion stretching to avoid equinovarus.
52
What orthotics might someone use if part of their foot is amputated?
- a shoe filler to hold hindfoot in the shoe | - a rocker bottom
53
What foot amputation has a 30% failure rate?
transmetatarsal | d/t loss of weightbearing area and decreased ability to plantarflex well

Prosthetics- H (2 decks)

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