Amputation
Amputation
- Ray amputation – amputation of toe with head of metatarsal or metacarpals
- Gillies’s amputation – trans metatarsal
- Lisfranc’s amputation – tarso metatarsal amputation
- Chopart’s amputation – midtarsal amputation
Syme’s amputation
- Removal of foot with Calcaneum and cutting of tibia and fibula just above the ankle joint with retaining heel flap
- Elephant boot is used for limb after Syme’s amputation
- Mainly used for crush injury, infections
- Not done for: peripheral artery disease, peripheral artery disease
- Pirogroffs amputation – provides longer stump than Syme’s amputation
Below-Knee (Burgess) amputation
- Long posterior flap
- Better prosthesis placement with greater range of movements without limp
- Stump length is 14 – 17 cm from the knee joint
- Minimum length required for prosthesis is 8cm
Hip disarticulation
- Done whenever it is not possible to save the minimum 10cm length of the femur
Above knee amputation
- Equal anterior and posterior flaps
- Ideally required length of femur stump is 25cm from the tip of the trochanter
Exam Question
- Myodesis is employed in amputations is indicated for Tumor, Ischemia & children
- Myodesis is contraindicated in cases of severe dysvascularity in which blood supply to the muscle appears compromised.
- Tarso Metatarsal amputation is also known as Lisfranc amputation
- Amputation is required in Gas gangrene, Buerger’s disease & Diabetic gangrene
- In flap method of amputation, bone is kept shorter than the level of amputation
- Ring sequestrum is seen in Amputation stump
- MES score evaluates chances of amputation in a traumatized limb
- Age, B.P & Velocity of trauma evaluate the chances of amputation in a limb
- In below elbow amputation the length of stump should be 15-20 cm
- Distance from Olecranon in amputation should be 15-20 cm
- Phantom limb Follows amputation
- Pain due to post-amputation neuroma is best treated by Surgical Excision
- Most Imp. technical consideration at the time of doing below knee amputation is Post. flap should be longer than the anterior flap
- Extensive surgical debridement, decompression or amputation may be indicated in Progressive synergistic gangrene, Acute haemolytic streptococcal cellulitis & Acute rhabdomyolysis
- Liability for wrong limb amputation can be considered under Both civil and criminal
- Most common cause of amputation in India is RTA
Don’t Forget to Solve all the previous Year Question asked on Amputation
