Podcast
Questions and Answers
Which of the following is a common cause of amputation in the developing world?
Which of the following is a common cause of amputation in the developing world?
- Peripheral Vascular Disease (correct)
- Infection
- Trauma
- Tumour
What is a possible cause of amputation related to a vascular disease that is not associated with diabetes mellitus?
What is a possible cause of amputation related to a vascular disease that is not associated with diabetes mellitus?
- Osteosarcoma
- Buerger's Disease (correct)
- Necrotizing Fasciitis
- Peripheral Neuropathy
What distinguishes phantom pain from other types of pain experienced after an amputation?
What distinguishes phantom pain from other types of pain experienced after an amputation?
- It is a sharp, localized pain in the stump.
- It is a persistent and often debilitating pain perceived in the missing limb. (correct)
- It is caused by irritation of the nerves in the stump.
- It is often triggered by external stimuli.
Which of the following is NOT a common treatment for pain management after amputation?
Which of the following is NOT a common treatment for pain management after amputation?
What imaging technique is used to diagnose neuroma pain after amputation?
What imaging technique is used to diagnose neuroma pain after amputation?
Flashcards
Peripheral Vascular Disease (PVD)
Peripheral Vascular Disease (PVD)
A major cause of amputation in the developing world, accounting for 85-90% of cases.
Phantom Pain
Phantom Pain
Pain felt in the amputated limb, often persistent and can be aggravated by other medical issues.
Neuroma Pain
Neuroma Pain
Pain that develops at the site of nerve section after amputation.
Management Goals post-Amputation
Management Goals post-Amputation
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Pain Management Techniques
Pain Management Techniques
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Study Notes
Amputation and Prosthetic Management
- Epidemiology: In developing countries, peripheral vascular disease (PVD) accounts for 85-90% of amputations, while trauma accounts for 90% and tumours/congenital defects/infections account for 1-4%. Upper arm amputations are rare. Mortality rates are 55-65% in Syria.
- Etiology/Pathophysiology:
- Vascular Disease (in DM):
- Peripheral vascular disease (PVD)
- Peripheral neuropathy
- Non-DM Vascular Disease:
- Arteriosclerosis
- Buerger's disease
- Chronic venous insufficiency (progressive inflammatory thrombosis of small and medium blood vessels in arms and legs)
- Trauma: history of injury (e.g., crush injury), rest pain, gangrene, foot ulcers.
- Tumours: osteosarcoma, soft tissue sarcomas, metastasis.
- Congenital deficiencies: defects at birth
- Infection: necrotising fasciitis.
- Vascular Disease (in DM):
Management Goals
- Establish likely functional outcome and suitability for rehabilitation
- Set realistic goals (work, driving etc)
- Improve functionality, including reducing contractures and ulcers
Pain Management
- Distinguish stump pain from phantom pain: Phantom pain is common, often over time, and may be aggravated by local or systemic medical issues.
- Control swelling (with removable rigid dressing (RRD)), distraction techniques, massage/transcutaneous electrical nerve stimulation (TENS), medication (pregabalin, gabapentin, carbamazepine, TCAs), and prosthetics.
Neuromas
- Can form at the site of nerve section, pain starts some time after amputation.
- Diagnostic workup includes MRI
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