Patients for amputation do not usually present diagnostic difficulties as they are mostly referred with a history of peripheral vascular disease and extensive treatment. The gradual blocking off of the minor blood vessels causes gangrene in the toes and ulcers on the areas which suffer pressure. This is followed by invasion by bacteria which leads to soft tissue infection and then to infection of the bone. Treatment can be long and drawn out with repeated operations and attempts at lesser amputations, leading to a long period where the patient is non-functioning and in pain.
In cases where the amputation is due to injury or accident it is called traumatic amputation and may be related to severe fractures which are compound and the leg has badly damaged arteries and nerves. The best choice here might be a primary amputation versus attempted saving of the leg. Salvage attempts for the leg can result in the leg being painful and poor in function, limiting progress and encouraging depression. Once the injury has occurred a realistic assessment needs to be made as to the potential for the limb to function well and to decide to amputate should that lead to faster functional return and pain relief.
With amputation the major goal is to preserve the length of the leg and to get the maximum functional use from the limb. As the operation cannot be reversed the surgeon must be sure the decision is correct and the only limits are the medical fitness of the patient to manage operation. Because the patient’s poor medical status will likely be closely linked to their abnormal limb the operation should remove the negative influence on their health and may save their life. Preparation for the operation, rehabilitation and life after amputation is a multidisciplinary matter also involving physiotherapists, social workers and psychologists.
Surgical management of severe leg trauma has shown significant advances in the ability to perform microsurgery to the vascular structures, advanced fixation of fractures and techniques to promote revascularisation of tissues. Amputation may then be viewed as a failure if these techniques cannot save the limb, but viewing it as a reconstructive process is more positive, allowing an increase in useful functional capacity. Techniques of amputation have seen much less development and patients still consult with difficulties such as persisting pain, swelling, limited use of the prosthetic limb and feelings of instability.
During surgery the surgeons are careful to keep a good skin length so it can be folded across the remaining limb and not with significant tension, position muscle over the bone end and perhaps stitch opposite muscle groups together and cut the nerves when they are tensioned to some degree and position their cuts away from the limb end so they do not suffer future tension. A general rule for planning the length of the remaining limb is to give 2.5cm of length for every thirty cm of the person’s height. After the operation the wound is dressed and post operative analgesia given.
Once the patient has got over their immediate post-operative period they will be seen by the physiotherapist who will check their respiratory status, teach them positional exercises, encourage upper body exercise and assist with safe transfers and early ambulation as appropriate. After perhaps two weeks the physiotherapist may move on to muscle exercises of the extremity itself and may initiate densensitisation of the remaining limb. This reduces the sensitivity of the area so it is prepared for its job with weight bearing inside a prosthesis.
Around six weeks after the operation the state of the wound may permit the start of the planning period for wearing the prosthesis although some patients will never manage one because of impaired balance, muscle weakness or lack of understanding. There are many other potential complications to having an amputation which may interfere with restoring the patient to their maximum independence. There may be breakdown of the wound as healing is poor in patients with peripheral vascular disease, skin problems, swelling of the area, contractures of the nearby joints, pain and phantom limb pain and sensations.
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapy, back pain, orthopaedic conditions, neck pain, injury management and physiotherapists in Edinburgh. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK. Article Source:http://www.articlesbase.com/disabilities-articles/amputation-of-the-legpart-2-1498702.html
Related Posts - Learning to live all over again Learning to live all over again We, with a debilitating disease, like Myositis or MD know all about side issues. They are an integral part of the disease but are quite often lumped into the description and symptoms of the disease. Headaches, stiffness, high blood pressure, elevated cholesterol levels, lung......
- Alternative Therapy Alternative Medicine- An Overview The term alternative therapy, as used in the modern Western world, encompasses any healing practice "that does not fall within the realm of conventional therapy". Commonly cited examples include naturopathy [natural health Therapy], chiropractice, herbalism, traditional Chinese medicine, Unani, Ayurveda, meditation, yoga, biofeedback, hypnosis, homeopathy, acupuncture, and diet-based therapies,......
- Osteoarthritis And Rheumatoid Arthritis - Discover How They Are Different In The Next 10 Minutes! Osteoarthritis and rheumatoid arthritis are two different diseases that are most often confused with each other due to the similar symptoms. What are their differences and is there a common treatment for both of them? Find out the expert answers in this article.The research paper that has been released by......
- Congenital Facial Paralysis – birth Injury Congenital facial paralysis is one of the uncommon but very serious birth injuries. It occur 0.23-1.8% of new born children. Its treatment depends up on the etiology of paralysis and physical examination. This problem is very serious and can lead to several other problems for infant. Some of its effects......
- With Frozen Shoulder Exercise Is The Last Thing On Your Mind But Persevere For A Speedy Recovery Frozen shoulder is a painful condition that will catch a lot of us at some time or othe especially once we pass fifty. Up to thirty percent of people will suffer a shoulder injury and a lot of those will suffer with frozen shoulder. It is caused by damage to......
Related Websites - Is Your Exercise Routine Giving You A Headache? If you are finding that you develop consistent headaches or migraines, the answer may be in your workout, or more importantly, how you are working out. It is actually quite common to get a headache a few hours after exercising. This is due to the fact that sudden stress on......
- Burn Jel Plus Review If you have ever suffered from a minor burn at the hands of your oven, iron or hair appliances, you probably know that it is not a lot of fun. There are a host of old wives remedies that spring to mind, but few ever get the job done right.......
- When is MPLS the Best Choice For Your Network Backbone? You have an often confusing menu of choices for your voice/data network today. A hot option for multi-site networks is MPLS (Multi-Protocol Label Switching). Is MPLS the right choice for your business?MPLS provides for use of short tails into a large network. The tail price being a larger proportion......
- Forex Brokers: Tips That Will Help You To Make The Best Choice One of the most important things you're going to need to keep in mind when getting involved in the Forex market is that you must choose the Forex brokers available in the market. You cannot trade directly on the market and all trades must be performed through a broker. There......
- Metro Ethernet Or MPLS - Which is the Best Choice For Your WAN (Wide Area Network)? If you could choose only one technology for your wide area network .... metro ethernet or MPLS .... which would you choose and why?Keep in mind this is not a simple bandwidth solution question. Such as choosing "how much" .... between say DS3 bandwidth or OC3 bandwidth. This goes......
Related posts:
- The Causes Of Birth Injury An incident takes place when a baby suffers some physical...
- Natural Remedies For Inflamed Joints - Discover The Cure For Inflamed Joints In The Next 10 Minutes! Inflamed joints cause a lot of pain and discomfort for...
- Amputation of The Leg The amputation of a leg is a major happening for...
- Amputation of The Leg The amputation of a leg is a major happening for...
- Rheumatoid arthritis and Back Pain Rheumatoid arthritis causes back pain to occur. The disease is...
Related posts brought to you by Yet Another Related Posts Plugin.
