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.

The main objective in the rehabilitation of people following amputation is to restore or improve their functioning, which includes their return to work. Full-time employment leads to beneficial health effects and being healthy leads to increased chances of full-time employment (Ross and Mirowskay 1995). Employment of disabled people enhances their self-esteem and reduces social isolation (Dougherty 1999). The importance of returning to work for people following amputation the- fore has to be considered. Perhaps the first article about reemployment and problems people may have at work after amputation was published in 1955 (Boynton 1955). In later years, there have been sporadic studies on this topic. Greater interest and more studies about returning to work and problems people have at work following amputation arose in the 1990s and has continued in recent years (Burger and Marinc ?ek 2007). These studies were conducted in different countries on all the five continents, the greatest number being carried out in Europe, mainly in the Netherlands and the UK (Burger and Marinc ?ek 2007). Owing to the different functions of our lower and upper limbs, people with lower limb amputations have different activity limitations and participation restrictions compared to people with upper limb amputations. Both have problems with driving and carrying objects. People with lower limb amputations also have problems standing, walking, running, kicking, turning and stamping, whereas people with upper limb amputations have problems grasping, lifting, pushing, pulling, writing, typing, and pounding (Giridhar et al. 2001).

Amputation in Literature and Film: Artificial Limbs, Prosthetic Relations, and the Semiotics of “Loss” explores the many ways in which literature and film have engaged with the subject of amputation. The scholars featured in this volume draw upon a wide variety of texts, both lesser-known and canonical, across historical periods and language traditions to interrogate the intersections of disability studies with social, political, cultural, and philosophical concerns. Whether focusing on ancient texts by Zhuangzi or Ovid, renaissance drama, folktales collected by the Brothers Grimm, novels or silent film, the chapters in this volume highlight the dialectics of “loss” and “gain” in narratives of amputation to encourage critical dialogue and forge an integrated, embodied understanding of experiences of impairment in which mind and body, metaphor and materiality, theory and politics are considered as interrelated and interacting aspects of disability and ability.

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.

Written by experienced physiatrists, prosthetists, and therapists at the McGuire VAMC regional Amputee Center of Excellence, this book provides an introduction to the field of amputee care and prosthetics. Dedicated chapters on prescription of prostheses for the various levels and types of amputations in both the lower and upper extremity provide state-of-the-art guidance. Prosthetic gait issues and medical management including residual limb concerns are also addressed. Formatted and concise with key information highlighted throughout, this handbook will be a welcome point of care resource or study tool for trainees and practitioners in any field involved in rehabilitation of amputees and prosthetics.

Now in one convenient volume, Atlas of Amputations and Limb Deficiencies: Surgical, Prosthetic, and Rehabilitation Principles, Fifth Edition, remains the definitive reference on the surgical and prosthetic management of acquired and congenital limb loss. Developed in partnership with the American Academy of Orthopaedic Surgeons (AAOS) and edited by Joseph Ivan Krajbich, MD, FRCS(C), Michael S. Pinzur, MD, FAAOS, COL Benjamin K. Potter, MD, FAAOS, FACS, and Phillip M. Stevens, MEd, CPO, FAAOP, it discusses the most recent advances and future developments in prosthetic technology with in-depth treatment and management recommendations for adult and pediatric conditions. With coverage of every aspect of this complex field from recognized experts in amputation surgery, rehabilitation, and prosthetics, it is an invaluable resource for surgeons, physicians, prosthetists, physiatrists, therapists, and all others with an interest in this field.

Articles include: a method of residual limb stiffness distribution measurement; step activity monitor: long-term, continuous recording of ambulatory function; new horizons in stroke rehabilitation research; testing and evaluation of wheelchair caster assemblies subjected to dynamic crash loading; a steering linkage for short wheelbase vehicles: design and evaluation in a wheelchair power base: a technical note; augmentation of the 100 kg ISO wheelchair test dummy to accommodate higher mass: a technical note; and diabetic amputations in the VA: are there opportunities for intervention? Illustrated.