Authors: Huber L; Palmer E

Affiliation: Cinahl Information Systems, Glendale, CA

Editors: Richman

Source: CINAHL Rehabilitation Guide, EBSCO Publishing, (Ipswich, Massachusetts); 2017 Sep 15

Publication Type: Clinical Review - CEU, exam questions

Language: English

Major Subjects:  Aerobic Exercises
                       Amputation -- Rehabilitation
                       Balance Training, Physical
                       Bandages and Dressings -- Utilization
                       Edema -- Therapy
                       Functional Training
                       Gait Training
                       Heat -- Therapeutic Use
                       Limb Prosthesis -- Utilization
                       Lower Extremity -- Pathology
                       Lower Extremity -- Surgery
                       Manual Therapy
                       Muscle Strengthening
                       Pain -- Prevention and Control
                       Patient Education
                       Peripheral Vascular Diseases -- Surgery
                       Phantom Limb -- Therapy
                       Physical Endurance
                       Physical Therapy Assessment
                       Skin Care
                       Stretching
                       Therapeutic Exercise
                       Transcutaneous Electric Nerve Stimulation
                       Trauma -- Surgery
                       Treatment Outcomes
                       Ultrasonic Therapy
                       Vibration -- Therapeutic Use

Minor Subjects: Education, Continuing (Credit)

ICD-9:84.10; 84.11; 84.12; 84.14; 84.16; 84.17; 895.0; 895.1; 896.0; 896.1; 896.2; 896.3; 897.0; 897.1; 897.2; 897.3; 897.4; 897.5; 897.6; 897.7

ICD-10:S78.0; S78.1; S78.9; S88.0; S88.1; S88.9; S89.0; S89.1; S89.2; S89.3; S89.4; T93.6

Alternate Term:Lower Extremity Amputation: Physical Therapy

CE Module: Amputation, Lower Extremity: Physical Therapy--CE Module 

Entry Date:20090710

Revision Date:09/15/2017

Accession Number:T708442

Persistent link to this record (Permalink):http://search.ebscohost.com/login.aspx?direct=true&db=rrc&AN=T708442&site=rrc-live

 

  Description

·         Lower extremity amputation (LEA) is the removal of all or part of the lower limb.

 

·         Disarticulation is the removal of all or part of a limb through the joint.

 

·       LEAs and disarticulations:

·       Toe amputation – commonly at the metatarsophalangeal level. Prosthetic replacement is not common

·       Ray amputation – removal of toe and metatarsal. This can narrow the foot considerably, resulting in increased weight-bearing through the remaining metatarsal heads, with subsequent ulceration risk

·        Midfoot amputation – a disarticulation just proximal to the metatarsals. Cuneiform and cuboid tarsal bones are retained

·    Hindfoot amputation – in a Chopart amputation, the forefoot and midfoot are removed and the talus and calcaneus are saved. Other hindfoot amputations may include talectomy and calcaneal-tibial arthrodesis

·         Syme amputation – removal of the calcaneus and talus while preserving the heel skin and fat pad to cover the distal tibia (ankle disarticulation).

 

·        Transtibial amputation – the most commonly performed limb amputation:

·         Formerly referred to as below-knee amputation.

 

·       Knee disarticulation – usually performed in cases involving traumatic injuries. In patients with vascular disease, if the blood supply is good enough to allow a knee disarticulation to heal, a short transtibial amputation would also probably heal and would be the preferred amputation:

·       Transfemoral amputation –amputation through the femur, resulting in a short residual limb and absence of bony contours

·        Formerly referred to as above knee amputation.

 

·      Hip disarticulation – rarely performed. Patients often use crutches and no prosthesis because of increased energy requirements due to the weight of a prosthesis

·      Hemipelvectomy –even rarer than a hip disarticulation, it may be required in some cases of trauma or cancer involving the pelvis. Use of a prosthesis is extremely rare, and special seating is usually required