amputation
Chapter 9
Amputations, Prostheses, Braces
AMPUTATIONS AND PROSTHESES
Amputations- may be the result of congenital limb deficiencies or may be acquired.
Acquired amputations – are traumatic, ischemic, or surgical in origin.
Surgical amputation – is an ancient procedure.
*Amputation – is only the essential first step in a series of measures designed to achieve ultimately the maximum rehabilitation of the patient.
Indication
Welfare will be significantly improved by the removal of an irreparably damaged, deformed, dangerous, painful, or useless part of the body.
When the blood supply of a limb has been lost and cannot be restored.
Irreparable loss of nerve supply
When the limb is useless, unsightly, and subject to chronic ulceration and other trophic changes
The commonest reasons for amputation are:
1. Vascular disease or accident
2. Trauma
3. Tumor
4. Infection
5. Thermal, chemical, or electrical injury
6. Congenital anomaly
Vascular accident or disease
Local blood supply, especially in the lower limbs, may be destroyed suddenly by thrombosis or embolism or gradually by PVD such as arteriosclerosis or thromboangiitis obliterans
Limb w/ impaired circulation- arterial reconstruction
When an adequate blood supply cannot be maintained or restored – gangrene ensues and amputation
PVD – most common reason for amputation.
Trauma
When severe trauma has so destroyed the blood supply or so damaged the tissues of the limb that gangrene is inevitable or useful reconstruction is impossible.
*Replantation of traumatically amputated limbs is most applicable to sharp, clean amputations that can be treated within few hours of injury.
Tumor
Primary malignant tumor – osteogenic sarcoma is a classic example
*Amputation should not be done until it has been ascertained that the tumor is definitely malignant and that it cannot be treated satisfactorily by measures such as resection, irradiation, or both.
Infection
In acute
Amputations, Prostheses, Braces
AMPUTATIONS AND PROSTHESES
Amputations- may be the result of congenital limb deficiencies or may be acquired.
Acquired amputations – are traumatic, ischemic, or surgical in origin.
Surgical amputation – is an ancient procedure.
*Amputation – is only the essential first step in a series of measures designed to achieve ultimately the maximum rehabilitation of the patient.
Indication
Welfare will be significantly improved by the removal of an irreparably damaged, deformed, dangerous, painful, or useless part of the body.
When the blood supply of a limb has been lost and cannot be restored.
Irreparable loss of nerve supply
When the limb is useless, unsightly, and subject to chronic ulceration and other trophic changes
The commonest reasons for amputation are:
1. Vascular disease or accident
2. Trauma
3. Tumor
4. Infection
5. Thermal, chemical, or electrical injury
6. Congenital anomaly
Vascular accident or disease
Local blood supply, especially in the lower limbs, may be destroyed suddenly by thrombosis or embolism or gradually by PVD such as arteriosclerosis or thromboangiitis obliterans
Limb w/ impaired circulation- arterial reconstruction
When an adequate blood supply cannot be maintained or restored – gangrene ensues and amputation
PVD – most common reason for amputation.
Trauma
When severe trauma has so destroyed the blood supply or so damaged the tissues of the limb that gangrene is inevitable or useful reconstruction is impossible.
*Replantation of traumatically amputated limbs is most applicable to sharp, clean amputations that can be treated within few hours of injury.
Tumor
Primary malignant tumor – osteogenic sarcoma is a classic example
*Amputation should not be done until it has been ascertained that the tumor is definitely malignant and that it cannot be treated satisfactorily by measures such as resection, irradiation, or both.
Infection
In acute