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DEFINITION
Removal of the whole or part of an arm/hand or a leg/foot Amputations can occur after an injury (traumatic amputation) or deliberately at surgery
WHY TO AMPUTATE ??
A useful and painless artificial limb is better than a painful and non functional natural limb
INCIDENCE
tumors 3%
infections 1%
Other 4%
Neurological/ congenital 3%
INDICATIONS
a. b.
c.
PREPARATION
Prophylactic antibiotics Clean the limb and seal off infected or necrotic area
OPERATIVE PROCEDURE
1. 2. 3. 4. 5. 6. Flaps Division of skin and muscles Nerves Blood vessels Bone Closure
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STUMP LENGTH
In the upper arm and fore arm a 20 cm stump is recommended For lower leg a 14 cm tibial stump is ideal A stump a less than 8 cm is difficult to secure in a prosthesis In an above knee amputation a 25 to 30 cm stump is optimum
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SYME-AMPUTATION
Disarticulation of the foot with removal of both malleoli.
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PIROGOFFS AMPUTATION
Pre-Operative
Post Operative
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CHOPART'S AMPUTATION
Amputation of the foot at the midtarsal joint, the plantar soft tissues being preserved to make the flap
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LISFRANC-AMPUTATION
Amputation of the foot between the metatarsus and tarsus.
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GRITTI-STOKES AMPUTATION
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HINDQUARTER AMPUTATION
An operation involving removal of an entire leg and part or all of the pelvis associated with it.
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COMPLICATIONS
Hematoma
Infection
Flap necroses
Joint contracture
Neuromas
Phantom limb
Phantom pain
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CONCLUSION
Always try to treat the cause in order to avoid amputation If inevitable then dont delay it Always consult experts in artificial limb centers for maximum benefit
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Thank You
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QUESTIONS ??
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