Amputation Stump Examination

Sunday, December 25, 2022 23:13

History
1. Why did you come
2. What caused the amputation ?
3. What year / time of amputation ?
4. Post amputation complications ?
a. Phantom limb sensation
b. Neuroma / hyperalgesia scar
c. Contractures
d. Ulcers at pressure points
e. Recurrent falls
5. Mobility method ?
a. If crutches - inquire about crutch palsy
6. Otherside foot
a. Problems - neuropathy , DM
b. Footwear
c. Awareness of foot care advice
7. Smoking
8. DM control
9. QOLs and ADLs
a. Is he happy or is he motivated to achieve mobility

Examination

Major amputation
Below knee amputation
Above knee amputation
Hip disarticulation

1. Below knee / above knee

R/ S Below knee amputation , with stump closed with long

posterior flap technique
Stump length is adequate
Stump shape - conned or not
Scar - length , well healed
No pressure point callosities / ulcerations
Check for the mobility of knee / hip
Mobility is good / bad
Fixed flexion deformities

Inspect the other limb

Forefoot/midfoot/hindfoot abnormalities
Ulcerations

Palpation

Scar tenderness
Palpate for sharp bony edges
Neuromas - at the lateral edge especially - tap and see
Muscle bulk - atrophied

Check for the quads and hamstring power

Palpate for the pulse proximal

Offer other leg examination

Get the patient to sit of bed and lift with 2 hands pushiing the bed
To check the proximal muscle power

Complications of amputation
1. Haematoma
2. Infection
3. Flap necrosis
4. Joint contractures
5. Neuroma
6. Phantom limb sensation
7. Phantom pain
8. Failure to use a prosthesis