amputations of the lower extremity

AMPUTATIONS OF THE LOWER EXTREMITYNguyen Quang Ton Quyen

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

TRANSFEMORAL (ABOVE-KNEE) AMPUTATIONS

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

Short

Standard

Long

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

ischemic nonischemic

NONISCHEMIC LIMBS

• The level of amputation• Lever arm and circulation• Cause

• Ideal bone length: 12.5 to 17.5 cm• Rule: 2.5 cm/30 cm

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

0.6 cm - bone section

1.2 cm proximally

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

- control edema - limit knee contracture - protect the limb

AMPUTATION OSTEOPLASTY

• Ertl procedure

AMPUTATION OSTEOPLASTY

• Stops tib/fib motion - may lead to less pain• Provides broader distal bone surface - may

increase end bearing• Periosteal Flap used to cover end of tib and fib -

more normal intra-osseous pressure

• Improved outcomes have not been proven

ISCHEMIC LIMBS

• Blood supply better on the posterior and medial aspects• Performed at a higher level• Procedure of Ertl is contraindicated• Tourniquet

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

POSTOPERATIVE CARE

• Some areas may be tighter than others

• Become loose quickly

POSTOPERATIVE CARE

• Rigid dressing is preferred

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

TRANSFEMORAL (ABOVE-KNEE) AMPUTATIONS

Short

Medial

Long

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

•Surgeons completely understand •surgical principles•postoperative care•prosthetic design

•Use diagonal turn•Graduate the pressure•Promote a conical shape•Anchor the bandage

socket

knee

pylon

foot

$80