Lower Limb 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.

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.

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.

Part of the best-selling Operative Techniques series, Operative Techniques in Plastic Surgery provides superbly illustrated, authoritative guidance on operative techniques along with a thorough understanding of how to select the best procedure, how to avoid complications and what outcomes to expect. This stand-alone book offers focused, easy-to-follow coverage of lower limb reconstruction and amputation, all taken directly from the larger text. It covers nearly all plastic surgery operations for these specific areas that are in current use, and is ideal for residents and physicians in daily practice.

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.

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