20230526 Amputation quiz

Main aim of traction neurolysis of digital nerve in finger refashioning is to prevent:

• pain during pinching on stump

• scar hypersensitivity

• phantom limb pain

• hook nail deformity

In traumatic amputation at level of mid forearm, below are INCORRECT

• warm ischemia more than 6hrs at forearm is an indication for amputation

• MESS score is a very reliable indicator for amputation

• indicated for segmental amputation with gross contamination even after covering with adequate antibiotic

• indicated for psychotic pt whom unable to follow post revascularization and rehab protocol

Regarding Ray Amputation of MF:

• Transposition technique will allow earlier post op rehab compared to non transpose technique

• Dorsal Y shape incision allows better exposure of both 2nd and 3rd MCB

• Digital artery and nerve are explored and ligated from dorsum skin incision

• Deep transverse Intermetacarpal ligament should be removed to allow direct visualization of digital neurovascular structure

Regarding finger amputation:

• Healing with secondary intention for fingertip injury is preferred over refashioning for laborer to maintain the finger length

• Occlusive dressing wound allows faster recovery than refashioning amputation

• PIPJ disarticulation is preferred for heavy labourer compared to ray amputation as it allow faster wound recovery

• Reducing palm span in ray amputation will affect grip strength in heavy labourer

Regarding prosthesis for Upper limb amputee:

• UL prothesis fitting should be done after stump is well moulded and wound completely healed

• Myoelectric Prothesis is better than body powered Prothesis as they are cheaper in maintainence

• Prothesis combining myoelectric and body-powered components(hybrid) is heavier,causing less compliance

• Terminal device for prothesis should be tailored to each pt need for cosmesis vs functional prehension device