A History Of Limb Amputation

This book opens with a unique historical review of natural amputations due to congenital absence, disease, frostbite, animal trauma, and to punishment and ritual. The advent of surgical amputation and its difficulties form a major part of the book, summarising the evolution of the control of haemorrhage and infection, pain relief, techniques, instrumentation, complications, prostheses, results and case histories. Alternative procedures, increasingly important in the last two centuries, are also debated.

This book opens with a unique historical review of natural amputations due to congenital absence, disease, frostbite, animal trauma, and to punishment and ritual. The advent of surgical amputation and its difficulties form a major part of the book, summarising the evolution of the control of haemorrhage and infection, pain relief, techniques, instrumentation, complications, prostheses, results and case histories. Alternative procedures, increasingly important in the last two centuries, are also debated.

The majority of amputations in the western world today are due to vascular disease. Despite the advances in surgical treatment of this disease, particularly by reconstruction, it is a sad fact that the number of amputations performed in these countries each year for vascular disease is increasing. Most of these amputees are elderly and their life expectancy is short, so it is important that the treatment and rehabilitation that they receive is informed, appropriate, efficient and swift to enable them to return successfully to life in the community for their remaining years. Management of this group of patients has proved to be successful only if a multidisciplinary team approach is adopted. Until recently in the UK, this approach sadly has only been implemented by a few centres. However, with the publication of the McColl report into the prosthetic and wheelchair service in 1986, interest in the care of the amputee is growing throughout the country. This book covers all aspects of amputation from disease and diagnosis to rehabilitation and community discharge with emphasis on the man agerneut of the largest group, the vascular lower limb amputee. A team approach is described and emphasized as being essential for good results and subsequent successful return into the community. The role of each of the important disciplines is described in relation to the appropriate part of the rehabilitation phase.

Implement TMR with Your Patients and Improve Their Quality of Life Developed by Dr. Todd A. Kuiken and Dr. Gregory A. Dumanian, targeted muscle reinnervation (TMR) is a new approach to accessing motor control signals from peripheral nerves after amputation and providing sensory feedback to prosthesis users. This practical approach has many advantages over other neural-machine interfaces for the improved control of artificial limbs. Targeted Muscle Reinnervation: A Neural Interface for Artificial Limbs provides a template for the clinical implementation of TMR and a resource for further research in this new area of science. After describing the basic scientific concepts and key principles underlying TMR, the book presents surgical approaches to transhumeral and shoulder disarticulation amputations. It explores the possible role of TMR in the prevention and treatment of end-neuromas and details the principles of rehabilitation, prosthetic fitting, and occupational therapy for TMR patients. The book also describes transfer sensation and discusses the surgical and functional outcomes of the first several TMR patients. It concludes with emerging research on using TMR to further improve the function and quality of life for people with limb loss. With contributions from renowned leaders in the field, including Drs. Kuiken and Dumanian, this book is a useful guide to implementing TMR in patients with high-level upper limb amputations. It also supplies the foundation to enable improvements in TMR techniques and advances in prosthetic technology.

This resource addresses all aspects of combat amputee care ranging from surgical techniques to long-term care, polytrauma and comorbidities such as traumatic brain injury and burns, pain management, psychological issues, physical and occupational therapy, VA benefits, prosthetics and adaptive technologies, sports and recreational opportunities, and return to duty and vocational rehabilitation.