amputations of the lower extremity

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AMPUTATIONS OF THE LOWER EXTREMITY Nguyen Quang Ton Quyen

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Page 1: Amputations of the lower extremity

AMPUTATIONS OF THE LOWER EXTREMITYNguyen Quang Ton Quyen

Page 2: Amputations of the lower extremity

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

TRANSFEMORAL (ABOVE-KNEE) AMPUTATIONS

Page 3: Amputations of the lower extremity

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

Short

Standard

Long

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

ischemic nonischemic

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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

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

Page 9: Amputations of the lower extremity

TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

0.6 cm - bone section

1.2 cm proximally

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

- control edema - limit knee contracture - protect the limb

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AMPUTATION OSTEOPLASTY

• Ertl procedure

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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

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ISCHEMIC LIMBS

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

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

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POSTOPERATIVE CARE

• Some areas may be tighter than others

• Become loose quickly

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POSTOPERATIVE CARE

• Rigid dressing is preferred

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

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TRANSFEMORAL (ABOVE-KNEE) AMPUTATIONS

Short

Medial

Long

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TRANSTIBIAL (BELOW-KNEE) AMPUTATIONS

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

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

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socket

knee

pylon

foot

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$80

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