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At least 1,549 records · Page 86Linked to original sources
PubMed1984

Prostheses alignment: effect on gait of persons with below-knee amputations.

This study investigated the effect on gait of changing prosthetic alignment for five people with amputations. Three-dimensional angular kinematic data were recorded by electrogoniometers positioned at their hips and knees. Indices of symmetry were developed in time and frequency domains for motion data of lower limbs when walking. These measures of symmetry were determined at different prostheses alignment settings and used to assess the possibility of aligning below-knee prostheses on the basis of symmetry of lower limb motion. Optimal or neutral alignment of below-knee prosthesis, as selected by clinically experienced personnel, tended to minimize asymmetry of gait at the hips and knees for persons with below-knee amputations. The indices of symmetry showed that alignment changes to the prosthetic foot disrupt gait to a greater extent than do other alignment changes. Asymmetries of hip flexion-extension motions were more sensitive to alignment changes than were other asymmetries. An index was selected that showed sensitivity to changes in gait caused by changes in prosthetic alignment for below-knee amputations. Refinements and other applications of this index in rehabilitation are suggested.

Artificial Limbs↗
PubMed1981

Foetal megakaryoblastic abnormality associated with congenital limb amputation in the br/br rabbit.

Recent research on the br/br rabbit is summarized. In all homozygous individuals, limb amputations result from in utero haemorrhages which develop in the extremities and lead to necrosis. An inner-ear abnormality is observed in about 25% of the cases. By studying a large number of gestations and birth, we observed that homozygous crossings result in about 100% amputated animals while crossings between heterozygous and homozygous rabbits result in about 50% of the young being abnormal. Observations of megakaryoblastic cells in 15- and 17-day foetal liver show a predominance of immature cells in 15-day br/br foetuses. This abnormality disappears on day 17. The possible role of megakaryoblastic cells in br/br rabbit amputation is discussed.

Animals↗
PubMed1980

Cell behaviour and cleft palate in the mutant mouse, amputated.

Cleft palate with a genetic origin normally arises because of a failure of the palatal shelves to elevate or fuse. Until now attention in studies of palatal development development has been focused on two critical phases, those of elevation and fusion. In the mutant mouse, amputated, however, cleft palate arise because of a failure of the palatal shelves to make any significant outgrowth between the 12th day after conception when the palatal shelves are first observed and the 14th day when elevation and fusion normally occur. When cell proliferation (mitotic index) was measured in the palatal shelves on days 12, 13 and 14 no difference was found between mutant and normal. The failure of the mutant palate to grow cannot be accounted for on grounds of reduced cell proliferation. For this reason the palatal mesenchyme in 12.5-day and 14.5-day normal and amputated mice has been studied wit the scanning electron microscope. This work shows that the mesenchymal cells in the mutant palate are clumped together and have much greater areas of cell contact than are observed in the normal palate. The abnormal cell behaviour described in mutant palatal mesenchyme is typical of amputated embryonic mesenchyme in general, and in other cases has been shown to cause abnormal morphogenesis. We propose that aberrant cell behaviour causing an aggregation through increased cell adhesion inhibits palatal outgrowth in the mutant, and for this reason the palatal shelves subsequently fail to elevate and fuse.

Animals↗
PubMed1995

[Retrograde intravenous perfusion as ultima ratio in potential amputation patients with peripheral arterial occlusive disease].

In 21 patients with critical ischemia and/or inflammation of the leg facing possible amputation, retrograde intravenous perfusion (RVP) was used to administer fibrinolytics, vasodilators and antibiotics. Amputation was avoided in 15 patients. In 4 patients, RVP was interrupted due to unsuitable veins for putting in cannulas. After introducing a 3-in-1-Block (Winnie) for analgesia, 7 courses of treatment at least were reached before unbearable pain became a reason for stopping therapy. RVP should, therefore, be considered as the last resort in the treatment of critical ischemia and/or inflammation of the leg of patients facing possible amputation.

Aged↗
PubMed1976

[Caudal regeneration in Nicodrilus giardi (Ribaucourt) (Oligocheta, Lumbricidae): worms amputated at the end of summer diapause].

N. giardi collected at the end of the summer diapause were amputated at two levels of the posterior part of the body: After amputation of the 100 posterior segments (nearly half the body), the regeneration processes appear quickly. An amputation removing only the 30 posterior segments is followed by a reorganization in the injured area, but the worms are incapable of regeneration.

Animals↗
PubMed1994

Osteopenia in patients with above knee amputation.

Using dual energy x-ray absorptiometry, we studied 16 male patients with unilateral above knee amputations (AKA) with a mean age of 48 years (range, 23 to 66 years) who were full-time prosthetic users for more than 5 years. All prostheses were ischial weight bearing. All 16 subjects were found to have normal bone density in their spines and in the normal femurs when compared to nonamputation controls. However, a significant decrease of mean femoral neck bone density was found on the amputated side (0.68g/cm2, range, 0.52 to 1.01) when compared to the normal side (1.01g/cm2, range, 0.75 to 1.20) (p < .05). The mean bone density percentage difference between the two sides was 28% (range, 4% to 48%). There was a significantly negative correlation between the patient's age at the time of amputation and the severity of osteopenia (-0.73; p < 0.05).

Absorptiometry, Photon↗
PubMed1996

[Has amputation of the rectum by pure perineal approach or Lisfranc operation still a role in the treatment of rectal cancer?].

Amputation of the rectum by a purely perineal route, the Lisfranc procedure, has been progressively replaced by abdominoperineal methods. In the AFC survey made in 1987, a Lisfranc was used only 26 times in 5,274 patients in the survey. We performed a Lisfranc 8 times from 1980 to 1993 in patients over 80 years of age or with an ASA score equal to or above 3. There was one death due to multiple-organ failure 70 days after the operation. Overall mean survival was 17.8 months and reached 24 months for those who did not have metastasis as the time of the amputation. Quality of life was assessed as good. Two patients had a local recurrence 1 and 3 years after the operation. We thus suggest that amputation of the rectum using the Lisfranc procedure can be used for certain patients in which simple colostomy (with no effect on the rectal syndrome), radiotherapy (variable and limited response), chemotherapy and other palliative procedures (electro-coagulation, laser cryosurgery) would not be indicated. Whenever tumour exeresis appears to be possible, we suggest that this method is the best palliative procedure to propose in elderly patients with several organic disorders and for cancers of the lower third of the rectum. The procedure should not however be attempted in patients with advanced stage cancer and a survival time estimated at less than 6 months.

Adenocarcinoma↗
PubMed1998

Growth-related and antennular amputation-induced changes in the olfactory centers of crayfish brain.

Freshwater crayfish increase in size throughout their lives, and this growth is accompanied by an increase in the length of the appendages and number of mechanoreceptive and chemoreceptive sensilla on them. We find that in the Australian freshwater crayfish Cherax destructor, neuropil volumes of the olfactory centers increase linearly with body size over the entire size range of animals found in their natural habitat. The number of cell somata of two groups of interneurons associated with the olfactory centers (projection neurons and small local neurons) also increases linearly with the size of the animals. In contrast, axon counts of interneurons that represent a nonolfactory input to the olfactory centers show that these reach a total number in the very early adult stages that then remains constant regardless of the size of the animal. Only the axon diameter of these interneurons increases linearly with body size. Amputation of the antennule and olfactory sensilla reduces the number of projection and local interneurons on the amputated side. No change in the size of the olfactory centers occurs on the unamputated side. Amputation of the olfactory receptor neurons in crayfish therefore leads not only to a degeneration of the receptor cell endings in the olfactory lobe but also to a trans-synaptic response in which the number of higher order neurons decreases. Reconstitution of the antennule and olfactory receptor neurons in small adult crayfish is accompanied by the reestablishment of the normal number of interneurons and neuropil volume in the olfactory centers.

Aging↗
PubMed1996

Latissimus dorsi musculocutaneous free flap transplantation to salvage below-elbow amputation in an emergency operation: a case report.

We used a free latissimus dorsi musculocutaneous flap (LD m-c flap) to cover a large skin defect at the stump of a forearm in an emergency operation. The patient we discuss is a 52-year-old man. Amputation at the distal one third of the left forearm occurred after catching his hand and wrist in a machine. The amputated left hand was severely damaged and there were wide skin defects. The function of the elbow joint was well preserved. Both the radius and ulna were cut 7 cm distal from the elbow joint. A 20 x 8 cm square of LD m-c flap was transplanted, to the stump of the forearm. The flap survived without incident. The range of motion of the elbow joint was from 20 degrees to 85 degrees. The prosthesis was well fitted to the stump, and the patient returned to his workshop 9 months after injury.

Amputation Stumps↗
PubMed1976

Amputation for vascular disease.

Amputation for peripheral ischaemia still has a depressingly high early and late mortality, and morbidity and the end result are usually less than satisfactory. Individual surgeons probably see too few amputees to treat them with maximal efficiency, and these patients create a large burden on beds and resources. There is room for improvement in all aspects of our management of amputees. Primary healing rates might be better with less heroic attempts to obtain a distal amputation. Sepsis is lessened by the use of prophylactic antibiotics. Tight bandaging and the intra-operative fitting of prostheses are undesirable. Simple tests of skin blood pressure may aid prediction of the degree of ischaemia at the proposed level of limb section and the chances of healing. The late mortality is high and merits study of methods designed to reduce it such as long term anticoagulation.

Amputation, Surgical↗
PubMed1998

Traumatic forearm amputation with avulsions of the ulnar and median nerves from the brachial plexus.

A case of a traumatic forearm amputation and associated complete avulsions of the ulnar and median nerves from the brachial plexus due to a crush-traction injury of the distal part of the right forearm is reported. The patient also suffered a traumatic head injury. The injury of the upper limb and the general condition of the patient were so serious that an amputation at the 1/3 middle part of the forearm had to be performed.

Accidents, Traffic↗
PubMed1987

Treatment in serious lower limb injuries: amputation versus preservation.

A study of patients with serious lower limb injuries is presented. With these injuries it is important to decide whether the limb should be salvaged at the risk of losing a life. Seventy-six patients are described and compared with a group of patients with similar injury severity scores but without serious lower limb injury. It is concluded that it is often preferable to amputate the limb rather than to risk the patient's life. Attempts at preservation of a limb were unsuccessful in 20 of the 54 patients in whom this was attempted. Secondary amputation was often performed in unsatisfactory conditions because of general complications that had resulted from the delay.

Accidents, Traffic↗
PubMed1991

Cold-induced arterial spasm after digital amputation.

The incidence and intensity of cold-induced digital vasospasm was investigated in 18 patients with digital amputation injuries. Nine patients had undergone replantation surgery, while in the remaining nine cases the injury had been treated by stump revision and closure. The vascularity of the injured digits and of uninjured fingers in both hands, was studied. The results confirm that cold-induced vasospasm is no more conspicuous in replanted fingers than in amputation stumps. Pathological vascular reactions to cold were also common in uninjured fingers in both hands.

Adolescent↗
PubMed1985

Cross transposition of short amputation stumps for reconstruction of the thumb.

Cross transposition of digital rays is illustrated by a case of amputation of the thumb and the middle finger. A remnant of the stump of the middle finger was mobilised and brought on top of the first metacarpal, in order to restore a functional length to the amputated thumb. A cross transposition of the second digital ray to the third was also carried out, closing the gap left by the resection of the third metacarpal.

Adult↗
PubMed1998

Neuronal activity in the region of the thalamic principal sensory nucleus (ventralis caudalis) in patients with pain following amputations.

Thalamic neuronal activity has not been studied in a primate model of peripheral nerve injury. We now report neuronal activity in the region of the human principal sensory nucleus of thalamus (ventralis caudalis) in awake patients during the physiologic exploration that precedes surgical procedures for treatment of stump pain and movement disorders. All patients with amputations showed increased thalamic representations of the stump as reflected in both receptive and projected field maps. This suggested that thalamic re-organization involved both the afferent inputs from and the perceptual representation of the limb. The spontaneous activity of neurons in the region of ventralis caudalis representing the limb with the stump (stump area) was significantly different from that in other areas of the region of ventralis caudalis in patients with amputations (stump control areas) and in patients with movement disorders (control areas). The mean interspike intervals were significantly shorter for cells located in stump areas than for those located in stump control or control areas. Cells in all areas were found to fire in three different patterns: B group (burst) characterized by bursting activity, R group (relay) characterized as a Poisson process, and III group characterized by non-bursting, non-Poisson activity. Cells in the B group were significantly more common in stump control (41%) and stump areas (33%) than in control areas (15%). Bursting cells were found to have patterns consistent with the occurrence of a calcium spike (spike-burst pattern). The spike-burst pattern was most common among cells with receptive fields in the stump area. In these cells firing between bursts (primary event rate) was significantly higher than other cells in the region of ventralis caudalis, suggesting that spike-bursts are not due to hyperpolarization, i.e. low-threshold spikes. Spike-bursts often occur as a result of low-threshold spikes, when the cell is hyperpolarized. In contrast, spike-bursts in these patients were associated with increased interburst firing rates in cells with receptive fields. Thus bursting of these cells may have been due to high-threshold dendritic calcium spikes evoked by afferent input. In that case bursting could be involved in activity-dependent changes in thalamic function following deafferentation through a calcium-mediated mechanism.

Amputation, Surgical↗
PubMed1978

Case report: false aneurysm of the hand secondary to digital amputation.

A false aneurysm in an amputation stump of the second metacarpal produced a pulsatile mass and throbbing pain. Operative findings disclosed a false aneurysm arising from the digital artery on the radial side of the middle finger, with entrapment of the nerve to the ulnar side of the index digit within the aneurysmal sac. Excision of the aneurysm, relocation of the traumatic neuromas, and amputation of the index ray relieved the symptoms.

Adult↗
PubMed1992

[Radio-carpal amputation and prosthesis].

Radio-carpal amputation was rejected for a long time because of the difficulties of fitting both myoelectrical and mechanical prostheses, only allowing a purely aesthetic prosthesis. As a result of miniaturization of control systems and the progress in computers, we believe that this now constitutes the best site for amputation whenever it is possible. Preservation of the antero-posterior bony contours of the radius allows the use of short sockets attached by a system of clips. In this way, flexion-extension of the elbow is left free and the movements of pronation and supination can be used. Liberation of the proximal joints facilitates integration of the prosthetic hand.

Amputation, Surgical↗