Amputation

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

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