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At least 919 records · Page 51Linked to original sources
PubMed1975

Transferring load to flesh. Part VIII. Stasis and stress.

Those who suffer peripheral vascular disease (PVD) frequently require lower-limb amputation. To prevent further difficulties with circuation, the socket and support system of the resulting artificial leg should be arranged so as to prevent impairment of blood flow. The mechanical stress factors tending to impede flow and cause stasis are investigated. An assessment is made of the relative importance of the two types of stress, normal and shear, in reducing the flow within a simulated vessel surrounded by a model flesh.

Artificial Limbs↗
PubMed2006

Role of staged endoprosthetic revision with flap cover for limb salvage in endoprosthetic failure.

Endoprosthetic replacement (EPR) is commonly required for limb salvage in bone malignancies. Endoprosthetic failure is a term used to denote mechanical failure or infection usually requiring removal of the prosthesis. Treatment of infection consists of EPR revision with or without placement of a temporary spacer. Flap cover (either local or free) may be required if the overlying soft tissues are of concern. It is claimed that the investment of the endoprosthesis in well-vacularised soft tissue facilitates the eradication of infection. This series included nine patients with endoprosthetic failure due to chronic infection who needed flap cover. These patients underwent revision of the EPR in two stages. The first stage of revision included removal of the endoprosthesis, insertion of a spacer and soft tissue reconstruction. If serial sampling of the periprosthetic space failed to demonstrate microbial growth, the spacer was exchanged for an endoprosthesis. A total of nine patients underwent staged revision of endoprosthesis. In five patients cover was provided by a local pedicled flap and in four by a free flap. Patients undergoing cover by a broad flat musculocutaneous flap (i.e. free/pedicled latissimus dorsi) performed better. This study reports the results of attempted limb salvage in endoprosthetic failure due to infection in nine cases. Initial findings in this small series indicate that staged revision and soft tissue reconstruction in the form of muscle flap investment of the endoprosthesis carries a higher rate of successful limb salvage.

Adolescent↗
PubMed1998

Accuracy and precision of volumetric determinations using two commercial CAD systems for prosthetics: a technical note.

The aim of this study was to evaluate the validity and reliability of volume determinations using the commercially available Seattle ShapeMaker CAD/CAM system for production of prosthetic sockets and to compare it with the commercially available CAPOD system. We used three types of reference objects for volumetric determinations: steel tubes, plaster of Paris casts, and residual limb models. Three different sizes were examined for each type of object. Volume measurements with the two CAD/CAM systems were compared with measurements obtained by water filling, water immersion, or mathematical calculation (tubes only). We found an inconsistent systematic error of less than 3.1% for ShapeMaker and no systematic error for CAPOD. Random errors, represented by the coefficient of variation, were below 1.3% for the ShapeMaker and, in most cases, below 0.4% for the CAPOD. Theoretical changes in volume of 2.6% and 0.8% are possible to detect with these CAD/CAM systems. In our opinion, both systems have sufficient precision for routine clinical use in prosthetics and orthotics. However, in our study, the ShapeMaker committed larger random and systematic errors than CAPOD. This means that, according to our study, CAPOD offers the best possibility to determine and detect small changes in residual limb volume as a function of time.

Artificial Limbs↗
PubMed1998

[The rehabilitation of elderly amputees].

Rehabilitation of elderly amputees raises several issues. Taking into account that amputations are frequently performed in elderly patients, with vascular diseases, it seems relevant to ask whether it is preferable to perform an amputation and quickly rehabilitate the patient or to attempt revascularisation and save the patient's limb. The knowledge of the outcome of amputation is crucial for the choice of treatment. Therefore, we discuss limb amputation in old patients in terms of epidemiology, aetiology, functional characteristics, specific problems and results with regards to expectations. Types and characteristics of prostheses, as well as rehabilitation and cost-effectiveness are briefly discussed. It is concluded that amputation is a mutilating procedure which carries for the elderly a poor outcome in terms of rehabilitation. Consequently any surgical procedure that may spare the limb should be preferred.

Age Factors↗