amputation details

1. Amputation

2. Demographic data
Chief complain
History
PAIN
Phantom limb sensation: sensation of the limb that is no longer there. NORMAL to
occur
Phantom limb pain: cramping, burning, shooting pain perceived “in” the amputated
limb.

3. Phantom Limb Sensation
Phantom Limb Sensation:
This is any sensation of the missing limb except pain. Sensations include pins and
needles, tingling and prickling. Awareness of movement and positional orientation of
the limb are widely reported.

4. Residual Limb Pain
Residual Limb (RL) pain is pain experienced in the residual portion of the limb
Causes of RL pain may include neuromas – scarred nerve endings or nodules that
may cause abnormal ectopic firing of nerves as well as bony spurs in the residual
stump, localized skin disease and infection

5. Phantom Limb Pain
Often the temperature in the residual limb is lower, which is correlated to the
burning sensation that may be experiences as part of phantom pain
Muscle tension in the residual limb can increase the cramping associated with
phantom pain
Risk factors proposed for the development of phantom limb pain include the
severity of pre-amputation pain and post-operative pain, older age

6. Observation
Swelling,
Edema
Deformity
Skin, including scar
External appliances
Prosthesis evaluation - Improper socket fit, Improper prosthetic alignment,
Inadequate suspension
Stump - cylindrical, conical, bony, bulbous, or edematous
Gait

7. Palpation
Pain
Tenderness
Edema
Scar

8. Examination
ROM
Strength
Sensation
Skin assessment
Tightness, contracture
Endurance
Mobility skills
Balance

9. Prosthesis evaluation - Prosthesis Evaluation
Questionnaire
Prosthesis Function
 Usefulness,
 Residual limb health
 Appearance
 Sounds
Mobility
 Ambulation
 Transfers
Psychosocia Experience
 Perceived responses
 Social burden
 Frustration
Well-being

10. Stump measurements

11. Residual limb assessment
1. Color
2. Shape
3. Pulses
4. Edema (circumferential measurements)
5. Length
6. Skin condition
7. Sensation
8. Joint proprioception

12. Functional Assessment
Kerstein Functional Levels (ADL and mobility)

13. Narang Functional Levels (mobility only)

14. Francis Mobility Levels (mobility only)

15. Hanspal Mobility Levels (mobility only)

16. Siriwardena Walking Index (mobility only)

17. Barthel Index and FIM score