AMPUTATION.pdf,................PT MANAGEMENT

AMPUTATION.pdf,................PT MANAGEMENT

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  AMPUTATION Nishitha Elsy Fernandes Assistantprofessor- Nipt
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  CONTENTS •DEFINITION •INDICATIONS •IDEAL LEVEL •TYPES •TECHNIQUE •COMPLICATIONS •INDIVIDUAL AMPUTATIONS PROSTHESIS
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  DEFINITION •Amputation is the removalof a body extremity by trauma or surgery.
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  INDICATIONS Dead limb •Gangrene Deadly limb •Wetgangrene •Spreading Cellulitis •AV fistula •Malignancy Dead loss •Severe rest pain •Paralysis •Contracture •Trauma
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  IDEAL STUMP SHOULD- •HEALADEQUATELY •ADEQUATE BLOOD SUPPLY •ADEQUATE ADJACENT JOINT MOVEMENT •THIN SCAR WHICH DOES NOT INTERFERE WITH PROSTHETIC FUNCTION •ROUNDED EDGE WITH ADEQUATE MUSCLE PADDING •SUFFICIENT LENGTH TO BEAR A PROSTHESIS
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  TYPES •GUILLOTINE TYPE •FLAP METHOD •Circularflap •Elliptical/ Oval flap •Racquet method •Semicircular/ Rectangular method
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  COMPLICATIONS Early 1.HEMORRHAGE 2.INFECTION 3.DVT & PULMONARYEMBOLISM 4.GAS GANGRENE
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  COMPLICATIONS 1.ADHERENT & PAINFULSCAR 2.STUMP NEUROMA 3.PHANTOM LIMB 4.PAINFUL PHANTOM 5.SKIN FLAP NECROSIS 6.INFECTION OSTEITIS, SEQUESTRUM, SINUS 7.CAUSALGIA 8.FLEXION CONTRACTURE 9.JACTITATION 10.ULCERATION OF STUMP
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  LEVELS OF AMPUTATION ●Partial toe ● Toe disarticulation ● Partial foot/ ray resection ● Transmetatarsal ● Ankle disarticulation/ syme’s ● Long transtibial ● Transtibial ● Short transtibial ● Knee disarticulation ● Long transfemoral ● Transfemoral ● Short transfemoral ● Hip disarticulation ● Hemipelvectomy ● Hemicorporectomy
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  POST OPERATIVE HEALING- POST SURGICALDRESSINGS- •Rigid dressing, • Semi rigid dressing(unna’s dressing) , •Soft dressing- ❖ ELASTIC WRAPS-4 INCH WIDE OR MORE, OVER GAUGE AND DRESSING THE ELASTIC WRAPS ARE USED TO MAINTAIN COMPRESSION ❖ ELASTIC SHRINKERS
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  physiotherapy POSTSURGICAL PHASE PRE- PROSTHETICPHASE
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  POST OPPETIVE REHABILITATION •ACUTE PHASEOR POSTSURGICAL oPatient education oStump care- (RESIDUAL LIMB )dressing and promotion of healing, vascularity, wound health. oSystemic conditions oPositioning – elevation and positions to promote drainage
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  •ACUTE PHASE ORPOSTSURGICAL O Mobility O Balance and transfer O Maintenance of available range- of Active range of motion – residual limb care. O Chest physiotherapy – maintainance O Maintenance of the unaffected part of the body
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  POSITIONS
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  PROSTHETIC PHASE EXAMINATION ● RESIDUALLIMB ● RANGE OF MOTION ● MUSCLE STRENGTH ● STATUS OF UNINVOLVED LIMB ● FUNCTIONAL STATUS ● PHANTOM LIMB ● EMOTIONAL STATUS ● PSYCHOLOGICAL SUPPORT INTERVENTION
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  INTERVENTION LIMB CARE- WRAPPING- BANDAGING - TRANSTIBIAL+ TRANSFEMORAL SHRINKERS SKIN CARE ACTIVE RANGE OF MOTION EXERCISE BALANCE AND MOBILITY
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  EXERCISES
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  BALANCE TRAINING STATIC BALANCE DYNAMICBALANCE
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  USE OF PROSTHESIS Itis an artificial part and replacement of the lost part of the body It is the substitution to a part of the body to achieve its optimum function Eg; •Syme’s Amputation: Elephant boot ,Canadian Syme’s prosthesis, B-K Amputation: Patellar tendon bearing (PTB) prosthesis Solid ankle cushion heel(SACH), Above Knee Amputation: Suction type & Non suction type prosthesis,Hind quarter Amputation: Tilting table prosthesis(TTP) Canadian prosthesis
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  Prosthetic training STABILITY KNEE CONTROL STABILITYON PROSTHESIS PROSTHETIC CONTROL PROPRIOCEPTION PELVIC CONTROL STEPPING WITH PROSTHESIS
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  THANK YOU