Explain and define TMR during amputation surgery. What is its major importance in the
field of amputations and prosthetics?
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- Targeted Muscle Reinnervation (TMR) is a new elective surgery that
increases the number of (electromyographic) control signals, thus
improving the potential for enhanced prosthetic function. It can help to
prevent painful neuromas and decrease phantom limb pain.
- Involves transferring nerves that previously innervated muscles distal to
the amputation to denervate areas of unused muscles
- A greater number of electromyographic signals available may translate
into simultaneous control of the elbow and hand and also power a wrist.
Give a working definition of an elevated Vacuum Liner/Suspension.
,Give this one a try later!
- An elevated vacuum liner/suspension is where the residual limb is
continuously under vacuum as the pump creates negative pressure to
remove air from a sealed environment between the total surface bearing
socket and a wicked-liner. The vacuum created by a vacuum pump's
removal of air holds the intimately fitting liner firmly to the walls of the
socket by increasing the level of suction (decreasing the pressure) within
the socket.
- this is the future in prosthetics
Define knee disarticulation amputation. List a two benefit of this procedure. List two
detriments to this procedure.
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- amputation through the center of the knee joint
- benefits: residual limb can tolerate distal WB, no bones or muscles are cut
in surgery so strength/muscle tone/balance, LONG LEVER ARM, GOOD
BASE BC STILL HAVE FEMORAL CONDYLES
- detriments: poor prosthetic wear at bottom, leg has to squeeze through
small canal to reach bottom; bottom has to be a bulbous. Hard to get knee
centers equal
What is a Lisfranc amputation?
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, - tarsometatarsal disarticulation of the tarsal/metatarsal joint in an attempt
to maintain the transverse arch of the midfoot
- Results in significant gait disturbances as there is a high likelihood that the
foot will move into equinovarus deformity
-The patient will be non-weight bearing several days after surgery.
- This is common for osteomyelitis and gangrene
What is a Chopart amputation?
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- midtarsal disarticulation of midtarsal joint btw talus + navicular bones,
calcaneus, and cuboids (leaving calcaneus + talus intact)
- results in significant gait disturbances as there is a high likelihood that the
foot will move into equinovarus deformity
- pt will be NWB several days after surgery
- adequate wound clouse + sutures/staples have been removed then a
protected WB status can begin
- used in pts with a traumatic injury or bone or soft tissue tumor in forefoot
- preserves the ability for the pt to bear weight through the calcaneus,
however there is still a chance for the pt to develop an equinovarus
deformity
Arm swing is the product of trunk rotation where the shoulders flex to a maximum of
24 degrees during terminal stance and extend a maximum of 8 degrees at initial
contact. Trunk rotation 8-10 degrees occurs in opposition to pelvic rotation.
Collectively, these rotations permit:
, Give this one a try later!
- Arm swing provides balance, momentum, and symmetry of gait and is
directly
influenced by the speed of ambulation. With acceleration of gait, arm
swing excursion becomes greater, thus permitting a more efficient gait due
to increased forward momentum.
- Arm swing has also been shown to increase stride length, gait velocity,
and gait cadence. Therefore, maintenance of arm swing is necessary to
maintain functional gait.
when is an AKA performed?
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- There has been significant trauma to the proximal tibia and knee
- There is a tumor in the proximal tibia or distal femoral condyles that
cannot be
replaced by allograft or total joint replacement
- There is an infection or failure to heal following transtibial amputation
- Following failed revascularization of the lower leg
- At times for intractable infection following a TKA
List 5 positive effects of post-operative limb compression dressing and volume
management.
Give this one a try later!
field of amputations and prosthetics?
Give this one a try later!
- Targeted Muscle Reinnervation (TMR) is a new elective surgery that
increases the number of (electromyographic) control signals, thus
improving the potential for enhanced prosthetic function. It can help to
prevent painful neuromas and decrease phantom limb pain.
- Involves transferring nerves that previously innervated muscles distal to
the amputation to denervate areas of unused muscles
- A greater number of electromyographic signals available may translate
into simultaneous control of the elbow and hand and also power a wrist.
Give a working definition of an elevated Vacuum Liner/Suspension.
,Give this one a try later!
- An elevated vacuum liner/suspension is where the residual limb is
continuously under vacuum as the pump creates negative pressure to
remove air from a sealed environment between the total surface bearing
socket and a wicked-liner. The vacuum created by a vacuum pump's
removal of air holds the intimately fitting liner firmly to the walls of the
socket by increasing the level of suction (decreasing the pressure) within
the socket.
- this is the future in prosthetics
Define knee disarticulation amputation. List a two benefit of this procedure. List two
detriments to this procedure.
Give this one a try later!
- amputation through the center of the knee joint
- benefits: residual limb can tolerate distal WB, no bones or muscles are cut
in surgery so strength/muscle tone/balance, LONG LEVER ARM, GOOD
BASE BC STILL HAVE FEMORAL CONDYLES
- detriments: poor prosthetic wear at bottom, leg has to squeeze through
small canal to reach bottom; bottom has to be a bulbous. Hard to get knee
centers equal
What is a Lisfranc amputation?
Give this one a try later!
, - tarsometatarsal disarticulation of the tarsal/metatarsal joint in an attempt
to maintain the transverse arch of the midfoot
- Results in significant gait disturbances as there is a high likelihood that the
foot will move into equinovarus deformity
-The patient will be non-weight bearing several days after surgery.
- This is common for osteomyelitis and gangrene
What is a Chopart amputation?
Give this one a try later!
- midtarsal disarticulation of midtarsal joint btw talus + navicular bones,
calcaneus, and cuboids (leaving calcaneus + talus intact)
- results in significant gait disturbances as there is a high likelihood that the
foot will move into equinovarus deformity
- pt will be NWB several days after surgery
- adequate wound clouse + sutures/staples have been removed then a
protected WB status can begin
- used in pts with a traumatic injury or bone or soft tissue tumor in forefoot
- preserves the ability for the pt to bear weight through the calcaneus,
however there is still a chance for the pt to develop an equinovarus
deformity
Arm swing is the product of trunk rotation where the shoulders flex to a maximum of
24 degrees during terminal stance and extend a maximum of 8 degrees at initial
contact. Trunk rotation 8-10 degrees occurs in opposition to pelvic rotation.
Collectively, these rotations permit:
, Give this one a try later!
- Arm swing provides balance, momentum, and symmetry of gait and is
directly
influenced by the speed of ambulation. With acceleration of gait, arm
swing excursion becomes greater, thus permitting a more efficient gait due
to increased forward momentum.
- Arm swing has also been shown to increase stride length, gait velocity,
and gait cadence. Therefore, maintenance of arm swing is necessary to
maintain functional gait.
when is an AKA performed?
Give this one a try later!
- There has been significant trauma to the proximal tibia and knee
- There is a tumor in the proximal tibia or distal femoral condyles that
cannot be
replaced by allograft or total joint replacement
- There is an infection or failure to heal following transtibial amputation
- Following failed revascularization of the lower leg
- At times for intractable infection following a TKA
List 5 positive effects of post-operative limb compression dressing and volume
management.
Give this one a try later!
