Detialed orthopedics amputation and essential information needed to know by orthopedics resident doctors Introduction Defination Types of amputations Antomical requirment for every amputations

1. Presented by dr yasser baskoor
supervisor prof DR /abdualrgeeb
almarah
Dr ammar almaswari

11. Indications

24. When we can
amputate???🤔

27. Than what we
need to do???
🤔

28. In the past they used
to do this

30. For traumatic patient we
uses many score for
decision makeing of
amputation🤔

49. Here we will
see different
type and
names of
amputations

53. transhumeral versus
elbow disarticulation
advantages
indicated in children to
prevent bony overgrowth
seen in transhumeral
amputations

54. transhumeral amputation
maintain
4
-
5
cm proximal to elbow joint
if more proximal amputation is required
:
At least
5
-
7
cm of residual length is needed
for glenohumeral mechanics

66. Transfemoral Amputation
Maintain a
12
cm
(
10
-
15
cm
)
above knee joint for
prosthetic fitting
Technique
5
-
10
degrees of adduction is for prosthesis function
adductor myodesis
improves clinical outcomes
creates dynamic muscle balance )otherwise have
unopposed abductors(
provides soft tissue envelope that enhances prosthetic
fitting

68. Gritti-Stokes amputation
amputation through the femur near level of
adductor tubercle
synovium is excised to prevent postoperative
effusion
patella is arthrodesed to the end of femur for
improved end bearing
prepatellar soft tissue is maintained without
iatrogenic injury
improved outcomes as compared to
transfemoral amputation

70. Through-Knee-
Amputation
Indications
ambulatory patients who cannot
have a transtibial amputation
non-ambulatory patients
Technique
suture patellar tendon to cruciate
ligaments in notch
use gastrocnemius muscles for
padding at end of amputation

71. Below-Knee-Amputation )BKA(
Long posterior flap
12
-
15
cm below knee joint is ideal
(
10
-
16
cm of
residual tibia bone
)
need approximately
8
-
12
cm from ground to fit most
modern high-impact prostheses

72. Syme amputation
)noitalucitrasid elkna(
patent tibialis posterior artery is required
more energy efficient

73. technique
medial and lateral malleoli are removed flush
with distal tibia articular surface

74. Pirogoff amputation
)hindfoot
amputation
)
removal of the forefoot and
talus followed by
calcaneotibial arthrodesis
calcaneus is osteotomized and
rotated
50
-
90
degrees

77. Lisfranc amputation )midfoot
)
where the five metatarsal bones meet up with the
smaller cuboid bone and the medial, middle, and
lateral cuneiform bones. Ligaments hold these
bones in place

78. Transmetatarsal amputation
more appealing to patients who refuse
transtibial amputations
almost all require achilles lengthening to
prevent equinus

79. Transmetatarsal amputation
more appealing to patients who refuse
transtibial amputations
almost all require achilles lengthening to
prevent equinus

80. Great toe amputations
preserve
1
cm at base of proximal phalanx
preserves insertion of plantar fascia, sesamoids, and
flexor hallucis brevis
reduces
lrisk of ulceration

81. Name of this amputation
Q-What is the name of this
amputation????

82. Q-Why below the knee amputation better
than abovethe knee amputation??🤔

85. Lisfranc✌
👍

87. Above the knee
transfemural
amputation👍

89. The right answer
:vascular transtibial✌👍

91. Transmetat
arsal 😎

93. Wound Healing
Dependent on
vascular supply
nutritional status
immune status

97. Prognosis
outcomes are improved with
the involvement of
psychological counseling for
coping mechanisms
Involves a close working
relationship between rehab
physicians, prosthetists,
physical therapists, as well as
psychiatrists and social
workers

98. oN :yduts )PAEL(
tnacifingis
difference in
functional outcomes
with salvage vs.
amputation
.

99. Thank you for
your time