Amputations
Approach
- Expose legs from groin to toes
- Patient may be placed on chair
- Look
- Amputation stump / stump health
- Anatomical level of amputation (12 cm above knee, 14cm below knee)
- AKA: Equal anterior-posterior flaps
- BKA: long posterior Burgess gastrocnemius flap
- BKA: skew flap of Kingsley Robinson
- Feel
- Soft tissue should move freely
- Move
- Flex / extend joint
- Attach prosthesis
Completion
- Examine rest of limb
- Peripheral vascular examination
Indications for amputation
- Vascular: PVD, AV fistulae
- Infection: osteomyelitis, gangrene, necrotizing fascitis
- Trauma
- Malignancy
Complications of amputation
- Early
- Psychological / social problems
- Haematoma
- Wound infection
- DVT / PE
- Phantom limb pain
- Skin necrosis
- Late
- Osteomyelitis - infection transmitted through stump
- Stump ulceration
- Stump neuroma
- Flexion deformity
- Difficulty mobilising
- Spurs / osteophytes
