AMPUTATION-CONSEQUENCES

SUMMARY

1. Limb shortening.

2. Altered weight transmission: to surfaces that were previously non-weight-bearing (TTA, TFA), to surfaces that were weigh-bearing (TKA, Symes). Socket design is important in determining success.

3. Muscle loss: consider their function and not just individual muscles. TTA: loss of dorsi/plantar-flexion, inversion/eversion. TFA: loss of knee extension.

4. Muscle imbalance: loss of insertion points of agonists/antagonists leading to contractures. TFA: loss of adductors more than abductors as most are inserted into the greater trochanter.

5. Loss of joints: loss of invesrion/eversion of the ankle affects balance & stability on uneven ground; lack of dorsi/plantar-flexion leads to inability climb hills/ramps; loss of the knees leads to inability to perform activities in stances.

6. Loss of sensation: from skin and proprioception from joints & muscles.

7. Changed base of support & lack of proprioception.

8. Changed circulation: impaired venous & lymphatic return causes stump oedema.

9. Impaired heat loss: calculate according to 9% rule.

10. Increased energy cost of ambulation.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.