Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “AMPUTATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,369 records · Page 76Linked to original sources
PubMed1995

Major amputation of the upper extremity. Functional results after replantation/revascularization in 47 cases.

Over a 7 year period, 47 patients underwent replantation of complete (19) and revascularization of incomplete nonviable (28) amputations of the upper extremity. Revascularization of incomplete nonviable amputations had a success rate of 100 percent, where as replantation of complete amputations had a success rate of 74 percent. 37 of the 42 patients with successful replantations had satisfactory functional use of the replanted extremity.

Activities of Daily Living↗
PubMed1985

Advanced prosthetic techniques for below knee amputations.

Recent advances in the evaluation of the amputation stump, the materials that are available for prosthetic application, techniques of improving socket fit, and prosthetic finishings promise to dramatically improve amputee function. Precision casting techniques for providing optimal fit of the amputation stump using materials such as alginate are described. The advantages of transparent check sockets for fitting the complicated amputation stump are described. Advances in research that promise to provide more functional prosthetic feet and faster and more reliable socket molding are the use of CAD-CAM (computer aided design-computer aided manufacturing) and the use of gait analysis techniques to aid in the alignment of the prosthesis after socket fitting. Finishing techniques to provide a more natural appearing prosthesis are described. These advances will gradually spread to the entire prosthetic profession.

Amputation, Surgical↗
PubMed1989

A safe, pre-fabricated, immediate postoperative prosthetic limb system for rehabilitation of below-knee amputations.

Thirty-eight below-knee amputees were treated with a commercially available pneumatic prosthetic limb system, applied immediately postoperatively, that would allow immediate weight bearing following lower extremity amputation. Thirty-four limbs were amputated for peripheral vascular insufficiency and four were amputated due to trauma. Weight bearing was initiated an average of 4.7 days following surgery and patients were discharged with a non-removable temporary prosthesis at an average of 8.9 days. Thirty-three healed and were uneventfully fit with standard below-knee prosthetic limbs. Three required revision to the above-knee level. In a controlled setting, early weight bearing in the peripheral vascular insufficiency patient can be initiated with a low risk of local wound complication.

Adult↗
PubMed1989

Revision of painful distal tip amputations.

From 1968 to 1987, 22 patients were diagnosed with dysfunctioning digits after complete distal digital amputations. Each patient had the proximal portion of the partially amputated phalanx left within the injured digit. On average, 21 months after the initial injury, each patient underwent an excision of the remnant portion of the phalanx which averaged 6 mm (range 1 to 17 mm). All 22 patients reported excellent postoperative results of full function and no residual pain with an average follow up of 9 months. We theorized that localized synovitis produces joint pain related to: 1) nontolerated joint stress loading due to a change in the lever arm length of the amputated phalanx, or 2) inadequate cartilage nutrition owing to lack of stress applied to this joint. Maintaining digital length must be rethought with emphasis placed on painless function. Considering the losses to these patients in terms of time, employment, and money, a distal remnant measuring 4 mm or less should be excised, regardless of the digit, at the time of the injury.

Adolescent↗
PubMed2005

Upper-extremity digital amputation secondary to non-traumatic ischemia.

In an attempt to evaluate the factors that result in upper-extremity digital amputation secondary to acute non-traumatic ischemia, nine patients with digital amputations secondary to septic or non-septic emboli were evaluated retrospectively. Although some evidence was present in three patients, no primary focus of emboli could be confirmed in six cases. All patients were consulted about hand surgery > or = 7 days following the clinical suspicion of ischemia for different reasons. No patient had cardiac disease that might result in emboli. The most important factor that resulted in unfavorable prognosis was unknown or unproven primary focus of the emboli, including septic emboli. As a consequence, delay in recognition of the ischemia affects the outcome. Age, gender, and health condition before the incidence did not affect the outcome. Health condition of the patient at the time of diagnosis affects the outcome, as life-threatening conditions change the focus of attention and result in late recognition of the ischemia. Upper-extremity digital ischemia needs a high index of suspicion in cases with unknown or unproven primary focus of the emboli. Prompt recognition and early consultation seem necessary to prevent or reduce the extent of the amputation.

Adult↗
PubMed2004

Lower limb amputation in Jos, Nigeria.

OBJECTIVE: To determine the pattern of lower limb amputation (LLA) and highlight preventable causes in our hospital. DESIGN: A retrospective study. SETTING: University Teaching Hospital, Jos, Nigeria. SUBJECTS: Eighty seven patients who had LLA over a five and a half year period. There were 62 males and 25 females aged between three and 83 years (mean+/-SD = 44.5+/-21.1). MAIN OUTCOME MEASURES: Indications, morbidity and mortality. RESULTS: A total of 94 LLA were performed in the 87 patients managed. Trauma, diabetic foot sepsis and malignant conditions of the limb were the main indications for LLA in 26(29.9%), 23(26.4%) and 20(23%) patients respectively. Others were peripheral vascular gangrene (PVG) in eight (9.2%) patients; chronic osteomyelitis, three (3.5%); chronic leg ulcers, three (3.5%); Ainhum, three (3.5%) and snake bite in one patient (1.1%). Above knee amputation (AKA) was the most common procedure performed (48.9%) followed by below knee amputation (BKA) in 37.2%. There were 11 deaths (12.6%), out of which eight were due to sepsis with multiple organ failure following diabetic foot sepsis, two cases of clostridial myonecrosis complicating compound fractures and a case of metastatic osteosarcoma in a child. CONCLUSION: Majority of the cases of LLA could have been avoided with early presentation and appropriate management. A case is made for community health education on the need for early presentation to hospital for limb lesions.

Adolescent↗
PubMed1993

A historical look at the transmetatarsal amputation and its changing indications.

In March 1949, McKittrick described the use of the transmetatarsal amputation for the diabetic foot, along with specific indications. Infection, ischemia, and neuropathic ulcerations of the toes and forefoot were all treated with this procedure. In the past 30 years, however, advances in the management of these problems have led to a decrease in the number of transmetatarsal amputations performed at the New England Deaconess Hospital. With these advances, the current approach to the transmetatarsal amputation has changed, leading to significant modifications in the basic indications for this procedure.

Amputation, Surgical↗
PubMed1993

Tendo Achillis procedures for chronic ulcerations in diabetic patients with transmetatarsal amputations.

Recurrent ulceration following transmetatarsal amputation commonly results from hypertrophic bone formation or equinus deformity. In the current study, 31 diabetic patients underwent 33 Achilles tendon procedures for recurrent ulcerations at the distal stump of their transmetatarsal amputation. Primary healing was achieved in 21 procedures (64%) and secondary healing in 9 procedures (27%) for an overall healing rate of 91%. Two procedures failed to resolve the original ulceration (6%). The average follow-up examination was 27 months. The authors conclude that Achilles tendon procedures are an effective means of managing ulcerations in transmetatarsal amputation feet exhibiting an equinus deformity.

Achilles Tendon↗
PubMed2001

Subtotal pedal amputations. Biomechanical and intraoperative considerations.

Proper treatment for the compromised diabetic foot often requires surgical correction and subtotal pedal amputation. This article discusses various levels of amputation of the human foot, including digital, ray, transmetatarsal, midfoot, and Syme amputations. Surgical techniques and biomechanical considerations are presented in order to assist the surgeon in planning for the most functional outcome of the patient. A review of the literature and the experiences of the authors are presented.

Amputation, Surgical↗
PubMed2001

Continuous activity monitoring in persons at high risk for diabetes-related lower-extremity amputation.

This study evaluated the magnitude and location of activity of diabetic patients at high risk for foot amputation. Twenty subjects aged 64.6 +/- 1.8 years with diabetes, neuropathy, deformity, or a history of lower-extremity ulceration or partial foot amputation were dispensed a continuous activity monitor and a log book to record time periods spent in and out of their homes for 1 week. The results indicate that patients took more steps per hour outside their home, but took more steps per day inside their homes. Although 85% of the patients wore their physician-approved shoes most or all of the time while they were outside their homes, only 15% continued to wear them at home. Focusing on protection of the foot during in-home ambulation may be an important factor on which to focus future multidisciplinary efforts to reduce the incidence of ulceration and amputation. The ability to continuously monitor the magnitude, duration, and time of activity ultimately may assist clinicians in dosing activity just as they dose drugs.

Aged↗
PubMed2002

Syme's amputation. Surgical technique, prosthetic considerations, and case reports.

Amputation at the level of the ankle joint is a valuable but underused procedure for a variety of conditions affecting the foot and ankle. The procedure provides a comfortable and durable stump that allows the lower-extremity amputee to function with minimal disability. This article reviews the indications for Syme's amputation, provides a detailed surgical description of the procedure, and discusses postoperative prosthetic considerations. In addition, three case reports are presented in which Syme's procedure was successfully used as an alternative to higher-level amputation.

Adult↗
PubMedDate not supplied

Lower limb amputation.

The decision to amputate is a difficult one, but in some cases, amputation can greatly improve the patient's quality of life. Jo Gibson discusses the nursing care of patients undergoing amputation, with a view to helping them adjust to their changed circumstances.

Adaptation, Psychological↗
PubMed1976

Forefoot perfusion pressure and minor amputation for gangrene.

In many cases of digital gangrene, limited amputation to preserve the majority of the foot is possible. In the absence of invasive infection, forefoot perfusion pressure is the single most important factor in determining outcome of minor amputation. At ankle pressures of less than 35 mm. Hg, salvage of the foot appears to be futile. The presence or absence of diabetes mellitus has no noticeable effect on the result of amputation. Ankle systolic pressure measurement cannot supplant but should supplement clinical judgement in selecting surgical treatment for gangrene.

Aged↗
PubMed1976

The response of the brachial ventral horn or Xenopus laevis to forelimb amputation during development.

The normal development of the brachial ventral horn of the frog Xenopus laevis and the response of the brachial ventral horn to complete forelimb extirpation at five developmental stages were assessed histologically. Differentiation of brachial ventral horn neurons occurred in pre-metamorphic tadpoles between stages 52/53 and 57. Mean cell number in the brachial ventral horn reached a peak of 2576 (S.E.M. equals +/- 269, N equals 2) per side of the spinal cord at stage 55 and decreased to 1070 (S.E.M. equals +/- 35, n equals 7) by the end of metamorphosis. Cell degeneration was presumed to be the mode of cell loss since it was most prevalent during the period of rapid decrease in cell numbers. The response of the ventral horn to forelimb removal varied with the stage of the animal at amputation. Following amputation at stage 52/53 or 54 the ipsilateral ventral horn neurons appeared less differentiated than those on the control side and a rapid cell loss of about 80% occurred on the operated side. These effects occurred more rapidly after ablation at stage 54 than at stage 52/53. Amputation at stage 58, 61, or 66 caused chromatolysis in the ventral horn, a period of relative cell excess on the operated side, and a delayed neuronal loss of 32-66%. It was concluded that excess cell degeneration accounted for cell loss and that suppression of normal neuronal degeneration caused the relative cell excess on the operated side. The data indicate that the brachial ventral horn was indifferent to the periphery before stage 54, was quickly affected by limb removal between stages 54 and 58, and by stage 58 had entered a phase in which a delay preceded cell death. No forelimb regeneration occurred.

Age Factors↗
PubMed1999

Neutrophil count and amputation in critical limb ischaemia.

BACKGROUND: The white blood cell count (WCC) is known to be predictive of cardiac and cerebral vascular events. No one has yet investigated this in critical limb ischaemia (CLI). METHODS: Baseline WCC was examined in relation to lower limb amputation 6 months after a 4 week treatment period with i.v. placebo or i.v. taprostene in 366 patients with CLI. RESULTS: The WCC was related to a significant increase in amputation, relative risk 1.6 (p=0.001, 95% CI: 1.2-2.0) in CLI patients with WCC > or =9x10(9)/l vs patients with WCC <9x10(9)/l. Its association with disabling amputation persisted on logistic regression analyses which included cigarette smoking as a variable and also treatment group (p<0.001). The WCC is therefore an easily measurable prognostic variable in CLI. CONCLUSIONS: The white blood cell may promote intractable tissue ischaemia by capillary plugging and/or release of toxic chemicals and may have distinct effects on tissue viability.

Amputation, Surgical↗
PubMed1999

[Heterotopic replantation of fingers after traumatic amputation].

Available are the results of the treatment of 93 patients with multiple traumatic amputations of the fingers, in whom the heterotopic digital replantation was carried out. A total of 367 fingers were amputated, 187 of them have been replanted, which made up 51% of replantability. 148 fingers (79.1%) were replanted heterotopically and 39 (20.9%)--orthotopically. The viability was restored in 167 fingers, which made up 89.3%. Of 148 fingers, which have been replanted heterotopically, 88.6% have survived, and of 39 fingers, being replanted orthotopically, 92.4% survived. The analysis of functional results of the digital replantations in hand comprised the study of the hand biomechanics, blood supply and innervation. A total of 31 patients was followed up and examined in long term period from 8 months to 6 years after replantation. The biomechanics of the hand was assessed according to its capacities for seize and pinch as well as to the extent of movements in the joints of the restoration of digital innervation was assessed by the study of temperature and discrimination sensitivity. For evaluation of blood supply the US dopplerography and scintigraphy were used. The authors came to the conclusion that there was no substantial difference in the function of operated fingers both in orthotopic and heterotopic replantations. Taking into account that heterotopic replantation of the fingers resulted in more active digital function, it is safe to speak about more pronounced increase in the function of the hand in cases of heterotopic replantations of fingers in their multiple traumatic amputation.

Adolescent↗
PubMed1976

Amputation: two views.

It has been over one year now since his surgery, and Allen has returned to school and work, ambulating on his prosthesis most of the time. As his phantom limb pain decreased and his proficiency in walking increased, his acceptance of his amputation has been demonstrated in his comments and references to himself and his relations with others. As he states, the more comfortable he is about his amputation, the easier it is for others to accept and relate to him. This, I think, is the key to approaching that final stage of acceptance mentioned earlier. The more we can help our patients accept their amputation initially by supporting them through this crisis period, the easier it will be for them to relate to others and grow emotionally from these relationships.

Adaptation, Psychological↗
PubMedDate not supplied

[Amputation of the lower extremities in angiopathies and reamputation as a sequelae of postoperative complications].

In the period from January 1985 till January 1995 in the Clinic of Traumatology and Orthopedics of Military Medical Academy were treated 305 patients with 317 primary amputations of the lower extremities that were performed as the sequelae of ischemia and necrosis on the basis of occlusive changes, arteriosclerosis and diabetes. Out of the total number of operated patients, 210 were with diabetes mellitus. The amputations were performed at the level of: foot in 102 (32.17%), lower leg in 145 (45.74%) and upper leg in 70 patients (22.09%). Reamputations were performed in 52 patients (16.4%): at the level of foot in 22 (6.94%), lower leg in 17 (5.36%) and upper leg in 13 patients (4.10%). Tourniquet was used during the surgery of primary amputation in 56 patients.

Adult↗