Limb amputation

1. An Assignment On Limb Amputation.
Submitted By:
Group C,DVM 16th Batch
Student ID:
1804049,50,51,52,53,54,55,56
Level: 5 ; Semester: I
Faculty of Veterinary and Animal
Science
Submitted To:
Dr. Md. Ismail Hossen
Assistant Professor
Dept. of Medicine,Surgery and
Obstetrics
Faculty of Veterinary and Animal
Science
Hajee Mohammad Danesh Science and Technology University,
Dinajpur-5200.

2.  Definition:
. Amputation is surgery to remove all or part of a limb or extremity
(outer limbs),but technically it is more precise to reserve this term for
the process of limb removal by dividing through one or more of the
bones.
The term ‘disarticulation’ is more precise for the process of removing
a limb between joint surfaces.

3. Indication:
• Cancerous tumors in the limb.
• Frostbite.
• Gangrene (tissue death).
• Neuroma, or thickening of nerve tissue.
• Peripheral arterial disease (PAD), or blockage of the arteries.
• Severe injury, such as from a car accident.
 Congenital malformation of limb.
 Extreme heat or cold.
 Trauma- RTA, gun shot.

4. This Photo by Unknown Author is licensed under CC BY-NC
This Photo by Unknown Author is licensed under CC BY

6. SURGICAL ANATOMY
Femur is surrounded by a member of muscle which can
be divided into two major group i.e.
• Muscle of medial and muscle of lateral group.
• Muscles of medial group.
• Muscle of tensor fascia lata.
• Muscle biceps femoris.
• Muscle of semi tendinsous.
• Muscle of adductor.
• Muscles of lateral group.
• Muscle of Sartorius.
• Muscle of pectineus.
• Muscle of quadriceps and biceps femoris.

8. BLOOD AND NERVE SUPPLY
• Entire hindlimb is supplied by femoral and popliteal artery.
Nerve supply: Nerve supply is by sciatic, saphenous and
external popliteal nerve.
SITE OF OPERATION:
Amputation of hindlimb• Middle third of femur above
the stifle joint

10. Procedure of Anaesthesia:
 Intravenous regional local anesthesia (Bier's
block):In 1908, Bier introduced this technique.•
Intravenous regional analgesia is a simple and commonly
used technique to provide analgesia of the limb or digits for
amputation.In this technique, a superficial limb vein is
catheterized and local anaesthetic solution is injected The
limb vein is isolated from the general circulation by a
tourniquet.

11. Procedure:
The animal is restrained in lateral recumbency, with or without sedation.
The hair over a prominent on the relevant limb is clipped and the skin
prepared for injection.A tourniquet of stout rubber tubing or a wide flat
rubber band is applied above the carpus, or hack or the fetlock at a
pressure adequate to prevent arterial circulation 150 mmHG.Local
anesthetic, 2% lignocaine hydrochloride (preferably without
epinephrine) is then injected into the by inserting a butterfly needle or a
19gauge needle into the vein with its point towards the foot.After a
period of 15 minutes the area distal to the tourniquet is anesthetized
until the tourniquet removed.It is also used to a lesser extent for dogs to
enable amputation of the digit combined with system
sedation.Intravenous regional analgesia is safe for up to at
least 1.5 hours.

13. Surgical Procedure:
 A semicircular, lateral and medial skin incision is made.
 The lateral incision is gently curved from the fold of the flank and runin
the level at the mid shots of the femur.
 After reflecting the skin flop on the medial aspect at the middle of femur,
gracilis, sartorius muscle causal part is tran sected by blunt dissection.
 The femoral vessel is isolated and divided between two ligatures.
During the course of dissection, the femoral and popliteal artery are
ligated.
 The pectineus muscle is then transected at musculo tendineous
junction.
 Then quadriceps muscle and biceps femoris are tran sected at its
insertion point.

14. Surgical Procedure:
 Tran sected biceps femoris is reflected proximally and the sciatic
nerve is identified where it is served
 Then semi membranous, semi tendinous and adductor muscle
are tran sected at level of mid femur.
 Femur is then cut by bone saw and leg is removed. Hemorrhage
should be checked.
 Distal quadriceps muscles are sutured with adductor muscle so
that femur is completely covered.
 Biceps femoris is sutured to gracilis and semi tendinous muscle.
 The skin flap are brought and sutured apposition and edges are
sutured with mattress suture.

15. Post Operative Care:
 1.Parenteral antibiotic: Streptopenicillin (streptopen®, Renata
Pharmaceuticals Ltd) @ 1ml/10kg body weight intramuscularly at 24
hoursinterval for 7 days,
 2.Antihistaminic: Pheniramine maleate (Alerin®, Eskayef
Pharmaceuticals Ltd.) @ 0.5mg/kg body weight administered
intramuscularly at 24 hours interval for 7 days,
 3.Non-steroidal anti-inflammatory: ketoprofen (kop-vet®, Square
Pharmeaceuticals Ltd.) @ 3mg/kg body weight intramuscularly at 24
hours interval for 3 days.
 4.Dressing every alternative day for 7-10 days.
 5.Removal of suture at 8-10 post operative days.along with providing soft
bedding and restricted movement to enhance the healing of
the affected site.

16.  Referencs:
 Paul’s Handbook of General Surgery,Lameness and Radiology, 43-47pp, Ashit Kumar
Paul,DVM,MS,PhD.
 Surgical Techniques in Experimental Farm Animal.1995.F.A.Harrison.
 Ruminant Surgery.1996.Tyagi,R.P.S. and Singh.
 Image Sources:
 Google.
 Wikipedia.
 Youtube.

17. THANK
YOU