Artificial limbs, past, present and future.
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Amputation, Traumatic↗
Biomedical subjects
N M Mustapha
Publications and source records attributed to N M Mustapha.
The effect of oxygen inhalation and intravenous naftidrofuryl on the transcutaneous partial oxygen pressure in ischaemic lower limbs.
The effect of oxygen inhalation at atmospheric pressure and Naftidrofuryl infusion (N) on the TCpO2 is shown. At the central control site--5 cm below the midclavicular line--oxygen inhalation produced a significant increase in TCpO2, whereas there was no change after Naftidrofuryl infusion. At the 10 cm below-knee site, there were significant rises after oxygen inhalation alone, Naftidrofuryl alone and both combined. The study was conducted on 20 patients (23 legs). It is suggested that this study can form the basis for a regimen to improve the viability of ischaemic limbs showing borderline TCpO2 readings, and increase the chances of a successful below-knee amputation.
Adolescent↗
Transcutaneous partial oxygen pressure assessment of the ischemic lower limb.
As a result of these studies, it can be concluded that the TCpO2 is a reliable indicator of the state of perfusion of the skin in both the healthy and ischemic legs and can be used to predict the healing potential if amputation is performed. The most meaningful reading is obtained at 10 centimeters below knee anteriorly. The critical value is approximately 35 millimeters of mercury, since the pO2 value for below-knee amputations performed upon most patients with a 10 centimeter below knee amputation was less than this, further surgical treatment was required, while all patients with values above this underwent successful amputation. Determination of the 10 centimeter below knee-control site ratio does not appear to provide any further advantage over the absolute 10 centimeter below knee site value. However, the control site measurement should be taken to eliminate central circulatory failure. The technique can be easily undertaken by hospital technicians or regular nursing or junior medical staff. A site reading requires an average of 35 minutes. The capital outlay is well within the capability of an average general hospital, and the running costs are negligible.
Adolescent↗
Case note-a combined end-bearing and patellar-tendon-bearing prosthesis for Chopart's amputation.
Disarticulation between the proximal talus and calcaneous, and the distal navicular and cuboid (Chopart's disarticulation) was probably first performed in Britain by Syme in Edinburgh in 1829. Although initially successful, it fell into disrepute because of equinus deformity that developed as a result of the unopposed action of the soleus-gastrocnemius muscles and tendoachilles on the os calcis. Callosities and corns developed on the anterior aspect of the skin flap. These could become rather painful and troublesome at times. Nevertheless, it is an operation that is performed occasionally, and has a place in the range of conservative distal amputations of the lower limb. Whatever the views of the prosthetic team, they may be faced with a surgical "fait accompli" for which they have to provide a suitable prosthesis. There are various prostheses available but we describe a prosthesis required to fulfil a cosmetic, functional and combined end-bearing and patellar-bearing need.
Adult↗