Amputation

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  1. LEAP study outcome measures
    SIP (sickness impact profile) and return to work not significantly different btw amputation and reconstruction at 2 years in limb threatening injuries

    Most important factor to determine patient reported outcome is ability to return to work
  2. Leap study : decicion to amputate based on 2
    -Severe soft tissue injury: highest impact on decicion making

    • -Absence of plantar sensation: second highest
    • Not contraindication to limb salvage
    • Can recover in long term
  3. Metabolic demand of different amputations (% increased from baseline) 5
    • -Syme: 15%
    • -BKA: 25%
    • -AKA: 68%
    • -Through knee:most proximal level to maintain walking speed in children
  4. Amputation wound healing improved with 6
    • -Albumin >3
    • -Ischemic index >0.5
    • -Transcutaneous oxygen tension >30 mm hg
    • -Toe pressure >40 mm hg
    • -ABI > 0.45
    • -Total lymphocyte count > 1500
  5. Upper extremity amputations indications 5
    • -Vascular
    • -Soft tissue compromise
    • -Malignant tumor
    • -Infection
    • -COngenital anomalies
  6. BKA ideal location
    12-15 cm below joint
  7. Ertl amputation
    Creates a strut from tibia to ficula using a strut from the fibula.

    • Original > osteoperiosteal flap
    • Mofified. FIxation with screw, suture anchor or endo button
  8. Syme amputation:
    -definition
    -equirements
    -benefit
    • -Ankle disarticulation
    • -Patent tib post
    • -more energy efficient than midfoot amputation
  9. Chopart amputation:
    -definition
    -problem
    • -Hindfoot amputation: through TN and CC joints.
    • -Equinus deformity: do achilles lenghtening
  10. Complication in pediatric amputation
    -Bone overgrowth: Prevent by performing disarticulation or making an epiphyseal cap co cover medullary canal

Card Set Information

Author:
dcc77
ID:
334052
Filename:
Amputation
Updated:
2017-09-13 05:44:27
Tags:
Trauma amputations
Folders:

Description:
Orthobullets
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