Lower Extremity Amputation

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.

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.

"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"--

Prosthetic Restoration and Rehabilitation of the Upper and Lower Extremity is a well-illustrated, state-of-the-art reference on the science and practice of post-amputation care, prosthetic restoration, and functional rehabilitation, designed to maximize patient independence and quality of life. Chapters are written by physiatrists, prosthetists, surgeons, and therapists at the University of Michigan, clinicians and teachers who work with amputees on a daily basis. Clinically oriented, it covers both lower and upper extremity restoration and rehabilitation and serves as a handy reference for busy practitioners to support sound clinical decision-making. Beginning with basic anatomy, kinesiology, and a recap of surgical decisions principles and post-operative care for amputees, the book discusses biomechanics, clinical assessment, prosthetic options, how to write a complete and detailed prescription for the prosthesis, restoration and management of specific problems by region, and rehabilitation programs and strategies. Common medical issues such as phantom limb sensation and pain, skin problems, and sexual and psychological considerations are discussed as well. In-depth coverage of prosthetic restoration is provided for special populations such as infants, children, the elderly, athletes multi-extremity amputees, and those who have lost limbs to cancer. Chapters are written in expanded outline format for ease of use and feature numerous full-color diagrams, photos, and other illustrations. This text will guide physicians, trainees, and other members of the care team through the fundamentals of restoring function to individuals who have lost limbs or body parts. Key Features: Provides a state-of-the-art, accessible, clinical approach to post-amputation care, prosthetic restoration, and functional rehabilitation Covers both upper and lower extremities Addresses prostheses for special populations and sports and recreation Includes boxed clinical pearls at the start of each chapter, illustrated quick reference tables, and full-color photos throughout Supports clinical decision making and addresses practical questions and problems Advises on new requirements for Medicare and Medicaid patients, and includes patient education materials and sample prescription forms that can be customized for use in any clinic Outlines important information for returning to the community after amputation

This volume provides a concise and up to date resource that directly addresses the needs of general surgeons who perform vascular surgery by focusing on the diagnosis and clinical management of common vascular conditions. The volume is divided into sections on arterial disease, venous disease, vascular trauma, and vascular access. Chapters on arterial disease outline the management and surgical techniques for the treatment of acute limb ischemia, compartment syndrome, and diabetic foot infections. Chronic arterial disease is addressed in chapters devoted to the management of claudication, critical limb ischemia, and lower extremity amputation. The section on vascular trauma emphasizes surgical intervention for blood vessel injuries that occur in the neck, abdomen, and extremity. Vascular access chapters deal with the technical aspects and potential complications of temporary venous access catheters and permanent arteriovenous access for hemodialysis. More complex vascular topics are also covered with chapters that are shorter in length and focused on the diagnosis and a broad understanding of treatment options. Essentials of Vascular Surgery for the General Surgeon is the first of its kind to accurately mirror the SCORE curriculum for vascular disease as a patient care topic in general surgery training, acting as a “one stop” information source that general surgery trainees can turn to as a clinical reference and as a study guide for general surgery in service exams and board.

Comprehensive, practical, evidenced-based management of the diabetic foot.