Questions and Answers
What is the primary method for stabilizing muscle during procedures involving muscle transection?
What condition is cited as the most common cause of lower extremity amputation?
Which factor contributes most significantly to the development of neuromas in residual limb management?
What surgical technique is commonly used to achieve hemostasis during procedures involving amputation?
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In comparing the prevalence of amputations, which statement is accurate?
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What characterizes meromelia in terms of limb presence?
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Which medical management strategy aims at ensuring a healthy residual limb for prosthetic use?
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Which clinical manifestation is NOT typically associated with amputations?
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Which of the following describes hemimelia?
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Which percentage of hand usage is typically associated with the little finger?
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Study Notes
Maturation or Remodelling Phase
- Severe tissue damage results from amputation after an injury.
Clinical Manifestations
- Symptoms include pain, edema, and decreased function.
- Mechanisms of Injury (MOI):
- Amelia: Complete absence of at least one limb.
- Meromelia: Partial absence of at least one limb.
- Phocomelia: Absence of proximal bones.
- Hemimelia: Shortened bone condition.
- Adactyly: Absence of fingers.
Med/Surg Management
- Medical treatments include:
- Analgesics, such as oral opiates.
- Anti-depressants.
- Anti-inflammatory medications.
- Goals include creating a non-tender and healthy residual limb for prosthetic use.
- Surgical techniques involve:
- Myodesis: Attaching muscle to bone.
- Tenodesis: Attaching tendon to bone.
- Stabilization of muscles under tension for optimal healing.
Epidemiology
- Amputation prevalence is greater in lower extremities (LE) compared to upper extremities (UE) at a 5:1 ratio.
- Higher incidence in males than females.
- Peripheral vascular disease is the most common cause of lower extremity amputation.
- Trauma is the leading cause of upper extremity amputation.
Etiology
- Congenital anomalies show limb absence or abnormality evident at birth.
- Peripheral vascular disease occurs due to embolism or thrombus leading to ischemia, necrosis, gangrene, and ulceration.
- Amputation statistics:
- Single Above Knee Amputation (AKA): 65%
- Double AKA: 110%
- Single Below Knee Amputation (BKA): 40%
- Double BKA: 41%
- 1 AKA + 1 BKA: 75%
- With prosthesis: 60%
- Without prosthesis: 70%
Psychological Outcomes
- Depression is a common psychological occurrence following amputation.
Differential Diagnosis/Complications
- Surgical causes of amputation not present at birth include trauma, peripheral vascular disease (PVD), infection, and tumors.
- Congenital causes are evident from birth.
Types of Amputation
- Open Amputation (Guillotine Amputation): Indicated primarily in cases of infection.
- Closed Amputation (Flap Amputation): Stump is closed with skin flaps sutured over the bone end.
Surgical Procedures
- General amputation procedure involves the surgeon removing part or the entire limb based on the state of the extremity.
- Emphasis on healing includes:
- Careful handling.
- Controlling edema.
- Preventing infections.
- Wound healing protocols allow for one or two healing phases while constructing a resident limb for optimal prosthetic fitting and function.
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Description
This quiz focuses on the maturation or remodeling phase following thermal, chemical, and electrical injuries. It will explore clinical manifestations such as pain and edema, as well as the implications of amputations done after severe tissue damage. Test your understanding of injury recovery and management.
