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What is a major cause of amputations in persons over 50 years old?
What is the second leading cause of amputations?
What is the determinant of the kind of prosthesis the patient may use and the success of use?
Length of the residual limb
What are the 2 phases of postoperative management of amputation?
Heavy rubber-reinforced sock which gives compression; works well for transfemoral.
What does bandages and shrinkers provide?
What is the optimal transtibial limb shape?
What is the optimal transfemoral limb shape?
- Hard, plastic outer shell with hollow or foam interior.
- Body weight is carried by the walls of the shell.
- Pylon that may be covered with foam rubber to stimulate a leg.
- Body weight is carried by the pylon.
Custom molded receptacles for the residual limb.
What are provided over areas which are pressure sensitive?
Reliefs (less contact, less pressure)
What are molded over areas which are pressure tolerant?
Build-ups (greater contact, more pressure)
Contoured adducted trochanter-controlled alignment method
Used with very short transfemoral amputations, removal of femoral head from acetabulum, or hemipelvectomy.
Hip disarticulation prosthesis
What are the goals for surgical management of amputation?
- Remove the part of the limb.
- Allow for wound healing.
- Construct a residual limb for optimum prosthetic fitting and function.
What is the disadvantage of IPSF?
Does not allow for daily wound dressing and checking.
- Develops stength and endurance for all feasible types of mobility.
- Targets muscle groups important for use of prosthesis.
- Posterior part is resilient to absorb shock and to permit what substitutes as plantar flexion.
- Distal to MTP position, material is rubber which allows a rocker mechanism.
- Nonarticulated feet.
SACH - solid ankle, cushion heel
- Spring keel bends with weight, then straightens or bounces back.
- lightweight, more expensive
- Nonarticulated feet.
Energy storing, dynamic feet, elastic keel
- PF and DF provided with a mechanical joint.
- Degrees available can be adjusted.
- Articulated feet.
- Allows PF, DF, inversion, and eversion.
- More confirmation to uneven surfaces.
Why is total contact important?
- Provides counterpressure to assist with venous return and decrease edema.
- Enhances sensory feedback.
The patellar tendon is a very pressure ______ area.
- Aligned on the shank on slight flexion.
- Often, a slight knee flexion contracture is encouraged to facilitate the tendon weight bearing.
PTB - patellar tendon-bearing
An angular medial-lateral incision that places the scar away from bony prominences.
Gauze impregnated with a compound of zinc oxide, gelatin, glycerin, and calamine.
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