1.26 Amputation

Question 1

wrapping guidelines

Answer 1

• anchor above proximal joint line
• no creases
• no windows
• figure 8
• check for pain (appropriate pressure)
• no adductor roll for transfemoral

Question 2

What are the amputation types of the LE?

Answer 2

1. toe disarticulation
2. transmetatarsal
3. ray removal
4. ankle disarticulation
5. transtibial
6. knee disarticulation
7. transfemoral
8. hip disarticulation
9. hemipelvectomy
10. hemicorporectomy
11. rotationoplasty

Question 3

Who often gets toe disarticulations?

Answer 3

diabetics

Question 4

Which is the most important toe to save?

Answer 4

big toe

Question 5

transmetatarsal amputation

Answer 5

through midsection of tarsals

Question 6

What does a transmetatarsal amputation affect with respect to gait?

Answer 6

• affects toe off
• abbreviates stance
• faster swing on the opposite side (even shorter when painful)

Question 7

What is an ankle disarticulation also called?

Answer 7

Syme’s disarticulation

Question 8

What may be kept with a Syme’s disarticulation?

Answer 8

calcaneus

Question 9

Why would the calcaneus be kept?

Answer 9

• maintain the same leg length

- with enough padding, can walk with a peg leg

Question 10

What may be amputated with an ankle disarticulation (Syme’s)?

Answer 10

• may include removal of malleoli

- may leave calcaneus

Question 11

What is the goal of a transtibial amputation?

Answer 11

• keep the bone as long as possible

- want to same more of the gastroc and wrap around to the front to cushion the bony end

Question 12

What is the most important thing to keep if at all possible with an amputation?

Answer 12

• the knee

- need a stable knee for proper gait

Question 13

What is a knee disarticulation?

Answer 13

amputation with the femur intact

Question 14

Why are knee disarticulations not as common as other types of amputations?

Answer 14

If you try to create a knee joint, it will be below where the normal anatomy would be

Question 15

transfemoral amputation

Answer 15

• more muscle able to wrap around and attach so they can pull in opposition to one another
• want as long of a femur possible

Question 16

Why does the femur need to be as long as possible in a transfemoral amputation?

Answer 16

• longer lever arm

- easier to control prosthetic limb

Question 17

What is a hip disarticulation?

Answer 17

• still has a pelvis, but removes the entire leg

- salvage procedure

Question 18

prosthetics for his disarticulation

Answer 18

generally locked into knee extension

Question 19

What is a hemipelvectomy?

Answer 19

get rid of lower half of pelvis

Question 20

What is a hemicorporectomy?

Answer 20

• get rid of entire pelvis
• salvage procedure
• some people born that way

Question 21

What is particularly problematic with a hemicorporectomy?

Answer 21

pelvic floor muscles have nothing to act on

Question 22

What condition is rotationoplasty often used for?

Answer 22

Ewing sarcoma

• typically occurs in young males
• bone cancer that presents in distal femur or proximal tibia during puberty

Question 23

What is rotationoplasty?

Answer 23

• take the chunk out that’s bad
• rotate foot 180˚
• therapy to reach terminal extension
• foot placement for prosthetic

Question 24

benefit of rotationplasty

Answer 24

get knee control, essential for gait (PF is now extension)

Question 25

UE amputations?

Answer 25

can have them, but we don't see them as much