Lower Extremity Amputations Surgical Techniques
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Questions and Answers

What is the general consensus regarding the utilization of a tourniquet in patients with previous ipsilateral lower extremity revascularization?

  • It should be avoided due to safety concerns. (correct)
  • It is only recommended for specific cases with no alternatives.
  • There is no consensus on its usage.
  • It is considered safe and recommended for all cases.

Why is it important to check hemoglobin and hematocrit before surgery?

  • To assess the patient's risk for post-operative infections.
  • To determine the patient's blood type in case of emergency transfusions.
  • To ensure the patient is not anemic prior to anesthesia administration.
  • To establish a baseline for monitoring potential blood loss during surgery. (correct)

How many units of blood should be available at the time of surgery, as recommended in the text?

  • Exactly 2 units of blood.
  • At least 2 units of blood. (correct)
  • No specific recommendation provided.
  • At least 1 unit of blood.

Which stabilization technique is typically used for hindfoot fusions for long-term success?

<p>External fixation (B)</p> Signup and view all the answers

What is the purpose of positioning the calcaneus vertically in a Pirogoff amputation?

<p>To alleviate limb length discrepancy. (B)</p> Signup and view all the answers

Which of the following is NOT a recommended approach for stabilizing hindfoot fusions according to the text?

<p>Choparts Amputation (D)</p> Signup and view all the answers

What is a clear indication for transmetatarsal amputation based on the given text?

<p>Gangrene involving toes and metatarsals with stability (D)</p> Signup and view all the answers

What is emphasized in the text as essential to preserve to prevent equinus deformity after transmetatarsal amputation?

<p>Insertion of the tibialis anterior tendon (C)</p> Signup and view all the answers

What type of lesion would NOT be an indication for transmetatarsal amputation according to the text?

<p>Gangrene involving metatarsals but not toes (C)</p> Signup and view all the answers

When should an open transmetatarsal amputation be considered according to the text?

<p>When there is an infectious process extending to the web space (B)</p> Signup and view all the answers

What would be a detrimental outcome if there is loss of function of the tibialis anterior tendon after amputation?

<p>Equinus deformity (A)</p> Signup and view all the answers

What is the primary advantage of Syme's Amputation over below-knee amputation (BKA)?

<p>Allows for a longer length of the limb (A)</p> Signup and view all the answers

Which technique involves the utilization of the talus as a graft to help fill a defect at the fusion site?

<p>Modified Boyd's Kornah (C)</p> Signup and view all the answers

In the context of amputations, what is a benefit of utilizing the Calcaneus in surgical procedures?

<p>Advantageous for large heel ulcers with osteomyelitis (D)</p> Signup and view all the answers

What distinguishes a single-stage procedure like Syme's Amputation from a double-stage procedure?

<p>Ease of prosthetic construction (D)</p> Signup and view all the answers

Why is Syme's Amputation controversial in terms of stability and prosthetic construction?

<p>Uncertainty about the stability of the amputation site (B)</p> Signup and view all the answers

Which technique is particularly suitable for patients with ankle varus deformity and lateral ankle ulcers?

<p>Calcanectomy (C)</p> Signup and view all the answers

What surgical procedure involves disarticulation at the Talonavicular and calcaneal cuboid joint?

<p>Choparts Amputation (D)</p> Signup and view all the answers

Why is using the tourniquet not recommended in patients with previous ipsilateral lower extremity revascularization?

<p>Poses a safety risk due to compromised blood flow (A)</p> Signup and view all the answers

Which amputation technique involves full ankle disarticulation?

<p>Symes Amputation (B)</p> Signup and view all the answers

In which procedure is the calcaneus positioned vertically to help alleviate limb length discrepancy?

<p>Pirogoff Amputation (C)</p> Signup and view all the answers

What is the main reason for stabilizing hindfoot fusions in most cases for long-term success?

<p>To enhance prosthetic fitting (A)</p> Signup and view all the answers

Which technique involves utilizing the talus as an interposition bone graft if viable?

<p>Modified Boyd’s Amputation (C)</p> Signup and view all the answers

What is the primary indication for performing a ray resection according to the text?

<p>To treat verruca carcinoma (D)</p> Signup and view all the answers

In what scenario would transmetatarsal amputations NOT be recommended based on the information provided?

<p>Presence of psoriasis (D)</p> Signup and view all the answers

What condition would necessitate a hallux amputation in conjunction with a partial ray resection?

<p>Abscess or osteomyelitis of a toe (D)</p> Signup and view all the answers

Why might a patient with PVD require a wound vac after partial ray resection?

<p>To facilitate closure over raw cancellous bone (D)</p> Signup and view all the answers

Which procedure would be most appropriate for treating verruca carcinoma that requires wide excision?

<p>Transmetatarsal amputation (C)</p> Signup and view all the answers

What differentiates a transmetatarsal amputation from a partial ray resection based on the information provided?

<p>Extent of metatarsal removal (C)</p> Signup and view all the answers

What distinguishes a Syme's Amputation from a Boyd Amputation according to the text?

<p>Syme's Amputation allows for a full-length extremity, while Boyd Amputation involves tibialcalcaneal fusion. (C)</p> Signup and view all the answers

Which technique is advantageous for patients with large heel ulcers and calcaneal osteomyelitis, requiring a stable midfoot and forefoot?

<p>Partial Calcanectomy (B)</p> Signup and view all the answers

In what scenario is a transmetatarsal amputation particularly suitable?

<p>For a diabetic patient with Charcot arthropathy (B)</p> Signup and view all the answers

What is the primary advantage of a Calcanectomy compared to below-knee amputation (BKA) or above-knee amputation (AKA)?

<p>Ability to ambulate well with or without an assistive device (A)</p> Signup and view all the answers

What is the recognized problem in other amputations compared to Syme's Amputation?

<p>Anatomical and physiological disadvantages (A)</p> Signup and view all the answers

Why would a surgeon choose a Partial Calcanectomy over a Boyd Amputation for specific cases?

<p>For large heel ulcers with calcaneal osteomyelitis and stable midfoot/forefoot (D)</p> Signup and view all the answers

What is the primary indication for a transmetatarsal amputation based on the text?

<p>Extension of an infectious process to the web space (C)</p> Signup and view all the answers

What is emphasized as essential to preserve post-transmetatarsal amputation to prevent equinus deformity?

<p>Insertion of the tibialis anterior tendon (B)</p> Signup and view all the answers

Why might a transmetatarsal amputation be recommended over other procedures?

<p>To maintain angiosome integrity (A)</p> Signup and view all the answers

In which scenario would an open transmetatarsal amputation NOT be appropriate?

<p>Presence of neuropathic foot lesions (C)</p> Signup and view all the answers

What differentiates a transmetatarsal amputation from a ray resection?

<p>Preservation of metatarsophalangeal joint function (B)</p> Signup and view all the answers

What is a potential issue a surgeon may face during a transmetatarsal amputation if not addressed properly?

<p>Equinus deformity (D)</p> Signup and view all the answers

In the context of calcaneotomy, what is the primary reason for positioning the calcaneus vertically in procedures like Pirogoff amputation?

<p>Alleviating limb length discrepancy (C)</p> Signup and view all the answers

Which aspect is crucial in preventing equinus deformity after undergoing a tendon-related surgical procedure?

<p>Avoiding excessive plantarflexion (B)</p> Signup and view all the answers

What is an important consideration for a surgeon regarding angiosome in the context of amputations?

<p>Ensuring adequate arterial blood supply to the surgical site (B)</p> Signup and view all the answers

What could be a potential complication resulting from an error in performing a calcaneotomy procedure?

<p>Achilles tendon rupture (C)</p> Signup and view all the answers

How does proper management of tendons play a role in reducing complications after transmetatarsal amputation?

<p>Supporting proper gait mechanics (B)</p> Signup and view all the answers

What is a potential benefit of performing a Syme's Amputation compared to other amputations?

<p>Better preservation of angiosomes (D)</p> Signup and view all the answers

In the context of amputations, why might a surgeon choose to perform a calcaneotomy?

<p>To address large heel ulcers with calcaneal osteomyelitis (B)</p> Signup and view all the answers

What is a crucial consideration when deciding to perform a transmetatarsal amputation?

<p>Potential loss of tibialis anterior function (A)</p> Signup and view all the answers

How does utilizing the Calcaneus in surgical procedures contribute to patient outcomes?

<p>Enhances stability for ambulation (B)</p> Signup and view all the answers

Why is the preservation of tendon integrity crucial during amputation procedures?

<p>To maintain proper foot biomechanics (A)</p> Signup and view all the answers

What is a key consideration when assessing the suitability of a patient for a Syme's Amputation?

<p>Presence of neuropathic lateral ankle ulcers (D)</p> Signup and view all the answers

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