Lower Extremity Amputations Surgical Techniques

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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?

External fixation Signup and view all the answers

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

To alleviate limb length discrepancy. Signup and view all the answers

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

Choparts Amputation Signup and view all the answers

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

Gangrene involving toes and metatarsals with stability Signup and view all the answers

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

Insertion of the tibialis anterior tendon Signup and view all the answers

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

Gangrene involving metatarsals but not toes Signup and view all the answers

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

When there is an infectious process extending to the web space 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?

Equinus deformity Signup and view all the answers

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

Allows for a longer length of the limb 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?

Modified Boyd's Kornah Signup and view all the answers

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

Advantageous for large heel ulcers with osteomyelitis Signup and view all the answers

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

Ease of prosthetic construction Signup and view all the answers

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

Uncertainty about the stability of the amputation site Signup and view all the answers

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

Calcanectomy Signup and view all the answers

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

Choparts Amputation Signup and view all the answers

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

Poses a safety risk due to compromised blood flow Signup and view all the answers

Which amputation technique involves full ankle disarticulation?

Symes Amputation Signup and view all the answers

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

Pirogoff Amputation Signup and view all the answers

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

To enhance prosthetic fitting Signup and view all the answers

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

Modified Boyd’s Amputation Signup and view all the answers

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

To treat verruca carcinoma Signup and view all the answers

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

Presence of psoriasis Signup and view all the answers

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

Abscess or osteomyelitis of a toe Signup and view all the answers

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

To facilitate closure over raw cancellous bone Signup and view all the answers

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

Transmetatarsal amputation Signup and view all the answers

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

Extent of metatarsal removal Signup and view all the answers

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

Syme's Amputation allows for a full-length extremity, while Boyd Amputation involves tibialcalcaneal fusion. 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?

Partial Calcanectomy Signup and view all the answers

In what scenario is a transmetatarsal amputation particularly suitable?

For a diabetic patient with Charcot arthropathy 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)?

Ability to ambulate well with or without an assistive device Signup and view all the answers

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

Anatomical and physiological disadvantages Signup and view all the answers

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

For large heel ulcers with calcaneal osteomyelitis and stable midfoot/forefoot Signup and view all the answers

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

Extension of an infectious process to the web space Signup and view all the answers

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

Insertion of the tibialis anterior tendon Signup and view all the answers

Why might a transmetatarsal amputation be recommended over other procedures?

To maintain angiosome integrity Signup and view all the answers

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

Presence of neuropathic foot lesions Signup and view all the answers

What differentiates a transmetatarsal amputation from a ray resection?

Preservation of metatarsophalangeal joint function Signup and view all the answers

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

Equinus deformity 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?

Alleviating limb length discrepancy Signup and view all the answers

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

Avoiding excessive plantarflexion Signup and view all the answers

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

Ensuring adequate arterial blood supply to the surgical site Signup and view all the answers

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

Achilles tendon rupture Signup and view all the answers

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

Supporting proper gait mechanics Signup and view all the answers

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

Better preservation of angiosomes Signup and view all the answers

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

To address large heel ulcers with calcaneal osteomyelitis Signup and view all the answers

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

Potential loss of tibialis anterior function Signup and view all the answers

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

Enhances stability for ambulation Signup and view all the answers

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

To maintain proper foot biomechanics Signup and view all the answers

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

Presence of neuropathic lateral ankle ulcers Signup and view all the answers