Comprehensive Guide To Lower Extremity Amputations

"This text serves as a comprehensive guide for the care of patients requiring lower extremity major amputations. It details the indications, technicalities and procedural steps, risks and benefits to above-knee, below-knee and through-knee amputations. The textbook also details aspects regarding quality of amputation care, epidemiology of this disease and psychiatric considerations when managing patients with lower extremity amputation"--

The primary initial effort in every case of disease or injury should be to save the extremity. Amputation is seldom necessary following bone and joint injuries. More often, it is an admission of defeat in the medical management of the patient with vascular disease. In such cases, it should be performed only as a last resort. The longest possible lever arm, consistent with primary healing, should be maintained for maximum proprioceptive and kinesthetic feedback and thus rehabilitation potential.

Limb loss can occur due to trauma, infection, diabetes, vascular disease, cancer, and other diseases. Regardless of the cause, it often has a profound impact on a person's life. Many amputees experience feelings of loss and grief, frustration in learning to walk with an artificial limb, and difficulty adjusting to a new and challenging lifestyle. This book provides the practical knowledge needed to cope with the many changes caused by lower limb amputation. In clear, accessible language, it covers the medical, physical, and psychosocial issues and answers crucial questions such as: How do I cope emotionally with the loss of a limb? What steps can I take to prevent additional amputations? How do I treat and care for my post-surgery wound? What are the best prostheses for my particular needs? Can I play sports and exercise with a prosthesis? And much more! This unique resource aims to educate those with lower limb amputation so that they can better care for themselves and maximize their independence. The practical advice, tips, and extensive references within its pages will help individuals meet the challenges of leading full and fruitful lives.

The state-of-the-art guide to lower extremity reconstruction from international experts "I loved witnessing two generations of surgeons working together to capture it all: origin, evolution and progress, state of the art, and the future in one beautifully-crafted and exciting book. This is no doubt a must-read and must-have book." – from the Foreword by Fu-Chan Wei, MD Adequate evaluation of lower limb wounds for salvage requires an itemized assessment of vascular, osseous, soft tissue, and functional deficits. Lower Extremity Reconstruction: A Practical Guide by renowned reconstructive surgeons and perforator flap masters J.P. Hong and Geoffrey G. Hallock presents an orthoplastic approach to this growing and challenging area of microsurgery. Throughout the well-illustrated text and videos, an impressive cadre of international surgeons share pearls and insights, including esoteric knowledge and step-by-step demonstration of techniques with pertinent case examples. This unique guide presents a practical, visual, and stepwise approach to learning and mastering a full array of flap and microsurgery approaches for traumatic, dysvascular, metabolic, and oncologic lower limb defects. Organized into 26 topic-specific chapters, the book covers a full spectrum of lower extremity topics—from wound prep, timing, closure alternatives, and therapy, to soft-tissue tumors and a new concept in drop foot treatment. Numerous videos demonstrate how surgeons can leverage workhorse options to prevent chronic non-healing wounds or amputations and achieve the goal of limb salvage. Key Highlights Lower extremity soft-tissue reconstruction techniques using local muscle and perforator workhorse flaps Bone salvage and restoration techniques, including vascularized bone grafts Diabetic foot management with in-depth discussion of the SCIP flap and perforator-to-perforator concept Rationale for partial and subtotal foot amputation 27 videos and more than 600 illustrations enhance understanding of microsurgical interventions With insights from top microsurgeons on how to achieve the best outcomes for patients with lower limb defects, this is a must-have resource for plastic and orthopaedic surgeons, especially specialists who treat patients at trauma centers.

Systematic approach to evaluating patients, planning realistic outcomes, managing prostheses training, and much more.

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.