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At least 289 records · Page 16Linked to original sources
PubMed2003

Tophaceous gout in an amputation stump in a patient with chronic myelogenous leukemia.

Gout is a common rheumatologic disorder that can have an unusual clinical presentation. This case report describes the development of a gouty tophus at a site of remote traumatic forearm amputation in a patient with chronic myelogenous leukemia (CML). It further addresses the imaging characteristics of tophaceous gout as well as the differential diagnostic considerations as regards both the imaging findings and the clinical presentation.

Aged↗
PubMed2006

CAD/CAM evaluation of the fit of trans-tibial sockets for trans-tibial amputation stumps.

The purpose of this study was to objectively evaluate the fit of sockets for trans-tibial stumps in order to establish a guideline for use in the automated production of prosthetic sockets. Subjects were 24 trans-tibial amputees. Using a CAD/CAM system, 11 parameters regarding the 3D shape of the stumps and the sockets were objectively evaluated. A correlation was found between the activity level and the upper and lower volumes of the socket, and between the cause of amputation and the upper volume of the socket. It was considered desirable to make the lower part of the socket looser for patients with lower activity levels, to make the upper part tighter for patients with higher activity levels, and to make the upper part looser for amputation patients with peripheral circulatory diseases.

Adult↗
PubMed2001

Use of tissue expansion in revision of unhealed below-knee amputation stumps.

When local tissue is insufficient for the revision of unhealed below-knee stumps tissue expansion offers an interesting alternative for local coverage. We used this method in seven patients (five men, two women; mean age 30 years) who had had below-knee amputations, six of them after injury to a healthy limb and one for purpura fulminans. Ten tissue expanders were inflated slowly and intermittently either weekly or twice weekly depending on the patients. The mean expansion period was 92 days. Mean hospital stay for the two operations was 5.8 (range 4-9) and 7.6 (range 6-10) days, respectively. Using subjective and objective criteria, functional outcome was excellent in five patients and good in one. Expansion failed in one because of infection. Expanded skin flaps allow good cover with a minimal scar area in appropriate cases, while preserving the skin sensitivity and length of the tibial shaft.

Adult↗
PubMed2001

Human locognosic acuity on the arm varies with explicit and implicit manipulations of attention: implications for interpreting elevated tactile acuity on an amputation stump.

In Experiment 1, normal subjects' ability to localize tactile stimuli (locognosia) delivered to the upper arm was significantly higher when they were instructed explicitly to direct their attention selectively to that segment than when they were instructed explicitly to distribute their attention across the whole arm. This elevation of acuity was eliminated when subjects' attentional resources were divided by superimposition of an effortful, secondary task during stimulation. In Experiment 2, in the absence of explicit attentional instruction, subjects' locognosic acuity on one of three arm segments was significantly higher when stimulation of that segment was 2.5 times more probable than that of stimulation of the other two segments. We surmise that the attentional mechanisms responsible for such modulations of locognosic acuity in normal subjects may contribute to the elevated sensory acuity observed on the stumps of amputees.

Adolescent↗
PubMed1985

Management of infection of major amputation stumps after failed femorodistal grafts.

A retrospective review was performed of 174 patients who underwent 199 lower-extremity amputations for unreconstructable vascular insufficiency from 1976 to 1983 at the Northwestern University Medical Center. This study was initiated to identify the cause of amputation wound healing complications and secondary ascending prosthetic graft infection, as well as to propose a plan of management for the failed prosthetic grafts at the time of major limb amputation. Ninety-eight amputations were performed primarily, 12 were performed secondary to graft infection, and 89 were performed in patients who had previously undergone infrainguinal arterial bypass procedures. At the time of amputation, graft management consisted of high transection and suture ligation, allowing the graft to retract into the substance of the stump and away from the skin suture line and weight-bearing area of the limb. Delayed stump healing was noted to occur more commonly in the group who had undergone previous bypasses as opposed to those who had undergone primary amputation (34.8% versus 14.3%). Fourteen graft infections developed in 89 patients after amputation (15.7%), which is significantly higher than the overall 1.4% incidence of lower-extremity bypass infections that occurred during the same interval in patients with intact extremities. In addition, it was found that when infected grafts in amputated limbs were completely removed, stump healing without recurrent wound and graft sepsis was better than when treated locally or with partial graft removal. We therefore recommend removal of a thrombosed graft with an infected wound or an infected graft at the time of major limb amputation to decrease the incidence of wound complications and graft infection.

Amputation Stumps↗
PubMed2005

Fillet flap: a successful procedure to preserve the optimum length of below-the knee-amputation stump in congenital constriction band of the leg.

The use of 'spare part' tissue from an amputated segment to cover a stump with soft tissue deficiency is a viable option for augmenting the shape of the stump and preserving functional length of the stump without additional donor morbidity. The procedure requires no microsurgical skill if the tissues are used as pedicle fillet flaps transfer. This concept of fillet flap makes the amputation distal to an unfavourable definitive amputation site such as in congenital constriction band possible. We report herein a case of amputation distal to constriction ring to illustrate the application of fillet flap in reconstruction surgery.

Adult↗
PubMed1981

[The care of amputation stumps by osteo-myeloplastic according to v. Ertl].

The osteo-myoplastic operation of stumps induces the formation of an osseous bridge between the tibia and fibula. The surgical procedure consists of using flexible cortico-periosteal flaps after subcortico-periosteal resection of the osseous stumps. At the same time a myoplastic operation is performed connecting the adductors with the abductors, the flexors with the extensors respectively. The operation technique is described in details. With this treatment a stump is formed that permits exposure to pressure. The stump can be used like a heel. Besides further advantages by this operation the neuro-vascular system becomes normalized. This always causes the preoperative pains to be passed.

Amputation Stumps↗
PubMed1975

[Problems of peripheral nerve surgery in amputation stump pain and phantom limbs].

Follow-up examination of 17 patients with severe and lasting stump and phantom limb pain which could not be improved by analgetics and who then underwent surgical procedures at the neuroma. The results were discouraging. Only 2 patients showed a lasting improvement. Resection of the neuroma and injection of alcohol into the neuroma seem to be successful only if the preoperative history of pain is very short or if there is an isolated injury of a peripheral nerve and a subsequent single neuroma.

Amputation Stumps↗
PubMed1975

Pressure measurements beneath below-knee amputation stump bandages: elastic bandaging, the Puddifoot dressing and a pneumatic bandaging technique compared.

Elastic wrap bandaging is unreliable and dangerous in terms of pressure and pressure distribution (tourniquet effect). The Puddifoot dressing is safe and is less likely to produce a tourniquet effect. The range of pressures it produces is low--possibly too low to achieve ideal moulding or oedema control. A pneumatic bandage achieved a relatively narrow range of pressures between capillary and arteriolar blood pressures. It minimized tourniquet effects and differences between skilled and unskilled bandagers. It is sufficiently promising to merit development.

Amputation Stumps↗
PubMed1977

Electric pain control (EPC) of a painful forearm amputation stump.

Surgically and pharmaceutically uncontrollable pain in the forearm stump of a 28-year-old mine explosion victim of the Viet-Nam War, was successfully treated by electric pain control (EPC), which led to his full rehabilitation. The electrodes of the pain-control equipment were built into the prosthetic socket to enable treatment to be continued while the patient was working in his full-time occupation as a storeman. The theory underlying this form of treatment is briefly described and the method of manufacture of the modified prosthetic socket is provided, so that similar application of electric pain control can also be used in other patients.

Adult↗
PubMed1975

Electromyographic study of muscular activity in the amputation stump while walking with PTB- and PTB-suction prosthesis.

A comparative electromyographic study of the muscular activity while waling with PTB and PTB-suction prosthesis is presented. The PTB-suction prosthesis has been used clinically since 1969 with generally promising results. This prosthesis is mainly of value for patients with skin problems (poor sensibility and contact sores) and also has a cosmetic advantage. The present investigation has demonstrated that there is frequently a muscular activity pattern when walking with the PTB-suction prosthesis which is similar to that of a normal leg. The PTB prosthesis often shows a pattern of simultaneous contractions of antagonistic muscles. Furthermore, when the EMG-pattern is more "normal" and the amplitude higher with the PTB-suction prosthesis, it is probably the more suitable prosthesis. These EMG investigations can thus be a possible adjunct in the selection between the PTB-suction prosthesis and PTB prosthesis.

Adaptation, Physiological↗
PubMed1984

Amputation stumps studied by bone scanning. Work in progress.

Nine diabetic and 7 nondiabetic (post-trauma) patients 24 to 63 years of age (mean, 49) were scanned following amputation below the knee, which was bilateral in 4. A three-phase scanning technique (flow, blood pool, and delayed equilibrium images) was employed, using Tc-99m-etidronate. Duration of the arterial and capillary phases was estimated during flow. Activity at the tip of the stump was plotted as a function of (a) time since amputation and (b) flow measurements. Activity was found to diminish over a period of nearly 50 months, usually becoming minimal or undetectable after 18 months. The stump demonstrated relative stasis compared to the intact limb, particularly in diabetics and patients with long-standing amputation.

Adult↗