1/7. Custom skiing and trekking adaptations for a trans-tibial and trans-radial quadrilateral amputee.A keen skier who is a trans-tibial and trans-radial quadrilateral amputee sought an improved adaptation for skiing from the rehabilitation engineering Service in Edinburgh. The unpredictable nature of the bending moments and loads that can be imposed on the prostheses during skiing raised concern about the suitability of standard prosthetic components for this purpose. The authors report a ski boot modification that incorporates mechanical protection for the standard prosthetic components and a description of the custom-adapted alpine trekking sticks used also as ski poles. Reference is made to the role of risk assessment, the design and manufacture in providing this type of custom-made rehabilitation device.- - - - - - - - - - ranking = 1keywords = amputee (Clic here for more details about this article) |
2/7. pain and its absence in an unfortunate family of amputees.A family is described in which 5 male members sustained major traumatic injuries of their limbs. Two of these men had amputations of two of their limbs. The one surviving amputee is left handed. The development of phantom sensations, phantom pain and stump pain was unpredictable, despite their being first-degree relatives, and was independent of handedness.- - - - - - - - - - ranking = 1keywords = amputee (Clic here for more details about this article) |
3/7. Controlled environment treatment for limb surgery and trauma (a preliminary report).This paper demonstrates a new approach to postsurgical and post-traumatic wound management in the lower limbs. Our own results of 20 below-knee amputations are documented. A less detailed report is then given of experience with an additional 20 amputees: this second group includes experience not only here at Seattle but at five other centers in the united states. The same method for wound management and for control of edema was employed in all cases. The method, Controlled environment Treatment (CET), uses filtered air as a dressing medium, with a control console to maintain the pressure, constant or varying, according to a preset program. temperature and humidity are also controllable, as is gas composition. The limb, together with its controlled environment, is contained with a pliable, transparent, treatment bag, which permits inspection and palpation of the wound site without disturbing the bacteriologically sterile air within the chamber. A special seal reduces air leakage yet avoids constriction of the limb. This CET system was originally developed by the Department of health and social security, Biomechanical research and Development Unit, Roehampton, england. Subsequent developments are also noted of an improved Mark II CET Unit and of simpler, related, management systems for conditions not requiring sterile environments.- - - - - - - - - - ranking = 0.2keywords = amputee (Clic here for more details about this article) |
4/7. Marked bone spur formation in a burn amputee patient.This report presents an unusual case of a lower extremity burn amputee with a marked degree of bone spur formation. A 17-year-old man suffered 56% body surface area mixed-depth electrical and flame burns, necessitating left below knee amputation. He was admitted to a rehabilitation center 3 months postinjury for pylon fitting and gait training. Difficulty was encountered with poor skin tolerance to weight bearing because of the prominent distal bony margins in the stump. x-rays of the stump revealed a marked degree of linear bone spur formation, extending longitudinally from the distal tibia and fibula with multiple cross-bridges. The spur formation was considered an extensive bony exostosis of unclear etiology. Surgical revision was elected to obtain a stump more suitable for prosthetic tolerance, and to avoid a bulky "bypass" prosthesis. This stump revision enabled the patient to attain independent functional prosthetic ambulation. Although there is evidence of some recurrence of bone spur formation, this remains limited and asymptomatic.- - - - - - - - - - ranking = 1keywords = amputee (Clic here for more details about this article) |
5/7. pain memories in phantom limbs: a case study.pain experienced in a limb prior to amputation may influence the course of phantom limb pain many months later. Katz and Melzack (1990) found that 42% of their sample reported a 'somatosensory pain memory' which resembled the quality and location of a painful, or non-painful pre-amputation sensation. For many amputees, pain memories are vivid experiences which incorporate both emotional and sensory aspects of the pre-amputation pain (Katz 1992). Katz and Melzack (1990) suggest that sensory input will 'trigger' somatosensory pain memories while the affective component of a pain memory is generated by the intensity, quality and location of the current experience of phantom limb pain. The present case study used a diary design to examine whether 'triggers' could be identified for somatosensory pain memories. Over a 9-month period, the patient reported daily experience of ongoing phantom limb pain, generally confined to the distal part of the limb, and 5 episodes of injury-related phantom limb pain, primarily experienced in the calf of the missing limb. A 'trigger' was identified for each of the episodes of injury-related phantom limb pain, and a significant finding in this study was that two episodes of injury-related phantom limb pain were associated with cognitive and/or emotional, rather than sensory 'triggers'.- - - - - - - - - - ranking = 0.2keywords = amputee (Clic here for more details about this article) |
6/7. Cross leg flap in a bilateral traumatic amputee.A case report of a bilateral traumatic amputee who underwent a cross leg flap to preserve a knee disarticulation level amputation is presented. Salvage of amputated parts in the lower extremities to preserve stamp length provided our patient with better stability and decreased energy expenditure with ambulation.- - - - - - - - - - ranking = 1keywords = amputee (Clic here for more details about this article) |
7/7. Slow rehabilitation of a traumatic lower limb amputee.A 65-year-old male (GM) was referred to the physiotherapy department of the regional limb fitting centre for outpatient rehabilitation following a right transfemoral amputation five weeks previously. He had been knocked down by a bus and suffered a crush injury to the right leg resulting in a stable fracture to the right pubic ramus, a fractured skull and orbital bone. Immediately following admission to the local district general hospital, his right leg was amputated at the transfemoral level. He was nursed post-operatively in ITU for three days and was ventilated during this time. GM was then transferred to the general orthopaedic ward. He received physiotherapy throughout his hospital stay by ward-based physiotherapists--not experts in amputee management but with access to specialist advice. Early physiotherapy was primarily concerned with respiratory care and maintenance of limb mobility and function in bed. Gentle, active stump exercises were commenced on the first post-operative day. GM sat out of bed on the sixth day and stood with the support of two people on the eighth day. His wound was healing well and treatment in the physiotherapy gym began the same day. Use of the pneumatic post-amputation mobility aid (PPAM aid) (Redhead, 1983; Marks, 1996) was started on day nine. However, progress with this early walking aid (EWA) was slow and GM achieved independent walking using parallel bars on the eighteenth post-operative day.- - - - - - - - - - ranking = 1keywords = amputee (Clic here for more details about this article) |