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Amputations (Examination (Inspection
Stump anatomical level
Stump…
Amputations
Examination
Inspection
- Stump anatomical level
- Stump health
- Evidence of chronic vascular disease
Palpation
- Soft tissue under skin should move freely over the bone
- Proximal pulses
Move
- Ask pt. to actively flex and extend the knee joint above the amputation
- Many pts. have a fixed flexion deformity after
BKA
- Ask to look @ prosthesis and see pt. walk c¯ it.
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Viva
Indications: 4D’s
Dead: PVD (90%), thrombangiitis obliterans
Dangerous: sepsis, malignancy
Damaged: trauma, burns, frostbite
Damned nuisance: pain, neurological damage
Considerations
- Psychosocial implications
- Future mobility: 200% more effort to walk after AKA
- OT involvement
- Level of amputation must be high enough to ensure healing of the stump.
- But ↑ mortality w/ AKA vs. BKA
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