1. Short Case
A case of an amputation stump
Presenter: Dr Ananda M Hegade
Guide: Dr Ajay H Bhandarwar
Dr Rahul
2. • A 54 year old female patient resident of Byculla, house wife by
occupation underwent left sided below knee amputation for signs
and symptoms suggestive of diabetic foot 22days back.
• Patient complains of pain in the amputation stump that is present
while dressing the wound , non radiating , relieved after few minutes
• No history of continuous throbbing pain associated with fever and
pus discharge from the wound
• No history of redness and swelling in the surrounding skin
3. • No history of pain , numbness at the wound area
• No history of restriction of movement of knee joint
• No history of sensation felt at the far end of the wound away from
the wound
• Care of the wound is done by resident doctor
• Patient does regular exercises as taught by doctors and
physiotherapist
4. Past history
• Patient is a known case of diabetes mellitus since 10years and was on
OHA
• Patient Is a known hypertensive on medication since 5years
• H/o laparoscopic cholecystectomy done 5years back and h/o open
umbilical hernia repair done 3 years back
• Not a known case of pulmonary tuberculosis, asthma
5. Family history
• Not contributory
Personal history
• Sleep, appetite, bowel, bladder -Normal
6. General physical examination
Patient is conscious , cooperative and oriented to time , place and
person
Vitals
Pulse 90 per minute
Blood pressure – 128/80 mm Hg
No pallor , icterus , cyanosis , clubbing , lymphadenopathy or edema
7. Local examination
• After taking a verbal consent and in the presence of female
attendant, patient was examined in a well lit room with adequate
exposure in supine position
• Right leg appears normal
8. Examination of the left lower limb
amputation stump
INSPECTION
• Attitude of limb – normal
• Length of stump – approx. 15cm from
tibial tuberosity
• An oval shaped irregular ulcer of approximate size
12x12cm over the left below knee amputation stump
• Margin – regular
• Edge – sloping edge
• Floor- pink granulation tissue present with minimal slough
• Surrounding skin is normal with no discolouration or dilated veins
9. PALPATION
• No raised temperature
• No tenderness
• Inspectory findings were confirmed
• Left below knee amputation stump measures 14cm from the tibial tuberosity
• Oval shaped ulcer of size 12x12cm present over the left below knee amputation
stump
• Margin regular
• Edge sloping
• Floor – pink granulation tissue, minimal slough , scanty serous discharge,
• Base – hard , no induration in the surrounding skin
10. Movements at
-the knee joint : flexion , extension normal
-the hip joint :Flexion, extension , abduction and adduction normal
Lymph node examination
No regional lymphadenopathy
