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Amputation
Amputation
Amputation
Acquired Amputation
Loss of a limb as the direct result of trauma or surgery.
Congenital amputation
The absence of part or all of an extremity at birth is more appropriately referred
to as congenital skeletal deficiency rather than a congenital amputation
Upper extremity amputation
amputation may be carried out within 2.5” above the anterior axillary
fold. In amputation at the shoulder, the head and neck of the humerus
should be preserved as possible to minimize disfigurement
Amputation of individual fingers
Thumb (most commonly amputated digit, and loss of this digit will impair
the patient’s ability to grasp objects)
Having the patient loss other digits, ability to grasp is affected but they will
still retain some grasping ability.
Multiple finger amputation
Having loss more than one digit, surgeons may be able to construct
muscles to aid grasping ability
Metacarpal amputation
Loss of the entire hand but wrist is still intact; the patient however doesn’t
have the ability to grasp
Wrist disarticulation
Loss of the hand, but upto the level of the wrist joint.
Technology now exists to have plastic sockets made to serve as wrists
although carpus disarticulation has occasionally been possible, this is not
often practical. Disarticulation at the radiocarpal joint is the much more
common site for total head amputation. The carpus is disarticulated at the
radiocarpal wrist, this has the advantage that the prosthesis is need not
include the elbow joint and the pronation and supination are retained
Forearm (transradial) amputation /
Below Elbow Amputation
Classified by the length of the remaining stump. As stump length
decreases, so does the patient’s ability to pronate.
the most proximal useful stump measures 1.5” below the insertion of the
biceps tendon. The prosthesis for this stump must be short to allow elbow
flexion yet long enough to hold the stump securely. This may be
accompanied with a special prosthesis
Elbow disarticulation
involves disarticulation at the ankle joints and may include removal of the
medial and lateral malleoli and distal/fibular flares
not done in vascular conditions as higher level is necessary due to
insufficient blood supply - allows good end
bearing, the heel pad being sutured into position over the distal end of
the tibia and fibula
prosthesis is difficult in this type
Pirgoff Amputation
transtibial amputation
best done at the junction of the middle and upper thirds of the tibia, between
8 and 18 cm. Below the tibial plateau
Below Knee Amputation (BKA)
Heart complications
such as heart attack or heart failure (when the heart has difficulty pumping
blood around the body), blood clots (venous thrombosis), infection at the site of
the surgery, pneumonia (infection of the lungs) further surgery being required
Complications
Planned amputations
involve the leg and are carried out in older people with a restricted blood supply,
who are in a poor state of health and who usually have a chronic (long-term)
health condition, such as diabetes
Emergency amputations
involve the arm and are usually carried out in younger people who are often in a
good state of health
Phantom Limb Sensations