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At least 307 records · Page 17Linked to original sources
PubMed1990

Primary closure of below-knee amputation stumps: a prospective study of sixty-two cases.

Between January 1, 1985, and December 31, 1988, we prospectively studied the outcome of 62 consecutive below-knee amputations with primary closure in 56 patients. There were 35 men and 21 women; mean age was 70 years. Above-knee amputation was performed for occlusion of the profunda femoris artery, acute thrombosis of a popliteal aneurysm with inadequate sural artery vascularity, intractable knee flexion contracture, suspended ischemia, and occasionally, when ischemia was found intraoperatively to extend proximally during below-knee amputation. Bedridden patients deemed unfit for prosthetic devices were also candidates for above-knee amputation. Fifty-four lower extremities (87%) were gangrenous and rest pain was present in eight patients (13%). Twenty-nine limbs (47%) were amputated primarily, 33 (53%) after failure of one or more revascularization procedures. Six patients had bilateral amputation. Forty patients (71%) were diabetic. Mean hospital stay was five days. Fifteen patients (27%) died during a mean follow-up period of 29 months. Eleven stumps (17.5%) required reoperation; five for postoperative infection, four for wound breakdown after a fall, and two for secondary abscess. Three secondary above-knee amputations (5%) were necessary. Of 44 below-knee amputations in diabetic patients, one had to be revised at the level of the thigh. Of 33 amputations after revascularization failure, one secondary above-knee amputation was necessary. Restoration of preischemic status was achieved after a mean of 58 days. Upon patient discharge from a rehabilitation center, 44 stumps (81%) were suitable to be fitted with prostheses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

A case of segmental myoclonus in amputation stump: evidence for spinal generator and physiopathogenetic hypothesis.

We describe a 68-year-old woman who experienced pain and phantom limb sensation following an above-the-knee amputation of the right leg. A month later, the patient had myoclonic jerks of the stump. Polymyo-graphic recordings showed synchronous jerks in the vastus medialis and adductors of the thigh on the right side. The patient responded to clonazepam. We conclude that the myoclonic jerks were of spinal cord origin.

Aged↗
PubMedDate not supplied

[Amputation stump pain: a therapeutic study (author's transl)].

A study has been done in a Thermal Army Hospital, concerning the suffering of amputed persons and their treatment by "tiapride". For 20 observations, it has been noted 11 excellent and 6 good results, by a mean treatment of 300 mg. Interesting results are particularly observed at the first appearance of the soreness, a better integration of this one has been proved, it has also been noticed that amputed patients tolerate much better their prosthesis.

Amputation, Surgical↗
PubMed1992

Revision of amputation stumps in Dodoma--Tanzania.

The records of Dodoma Orthopaedic Department, Tanzania were reviewed for the period July 1986 to December 1990 in order to identify the reasons for revision surgery. A total of 26 patients required revision surgery. Two main groups were identified. In the first group 4 patients had a higher level of amputation because of gangrene. In the second group 22 patients had revision surgery because of other stump defects caused by technical mistakes when carrying out the original amputation, or other complications.

Adolescent↗
PubMed1994

Ilizarov lengthening of a posttraumatic below elbow amputation stump. A case report.

Lengthening of a nonfunctional posttraumatic below elbow stump via Ilizarov technique is described. Preoperatively, the 5 cm ulna in the residual forearm provided an insufficient lever arm for practical use of a standard below elbow prosthesis. An additional 5 cm of ulnar length was achieved (100% increase) by distraction histogenesis, ultimately limited by impending necrosis of adherent skin covering the tip of the residual limb. Utilizing the Ilizarov technique, ulnar lengthening converted the functional level of the patient's amputation from elbow disarticulation to below elbow status.

Adult↗
PubMed1993

Stump problems in traumatic amputation.

Stump problems in amputations resulting from employment related injuries were investigated in 397 cases in the Chugoku and Shikoku districts of Japan between 1987 and 1991. Ninety-seven patients (24%) had stump problems which interfered the prosthetic fitting. Stump problems of the upper extremity were seen in about 9% (17 amputees), two thirds of which were skin troubles. Stump problems of the lower extremity were seen in about 37% (80 amputees). Certain complaints were associated with specific methods of amputation; abnormal keratosis in Syme's amputation, equinus deformity in Chopart's amputation, reduced muscle power in above the knee (A/K) amputation and joint dysfunction in below the knee (B/K) amputation. Adequate prosthetic fitting was achieved by the modification of the socket and alignment in almost all amputees with stump problems. In only two cases, Chopart's amputation required subsequent Syme's amputation due to equinus deformity with abnormal keratosis. In almost every case, stump problems are avoidable by means of surgeons' deliberate evaluation of the affected limb and adequate choice of the amputation level.

Accidents, Occupational↗
PubMed1984

[Painful stumps after digital amputations].

Two etiologic groups of painful digital amputation stumps may be seen, each calling for a different type of treatment. One-fourth of painful amputation stumps are due to excessive nociperception and their management usually consists of local treatment. The other three-fourths are due to thalamic sensitive deafferentation and call for neurosurgical treatment if discriminative sensitivity has not been reestablished in the painful zone. Intermittent thalamic stimulation is our choice and has led to recovery in 25 out of 26 patients who have been submitted to this type of treatment.

Amputation Stumps↗
PubMed1978

Amputation after development of collateral circulation. An arteriographic study in rabbits.

The vascular changes in the amputation stump after amputation on an extremity which is vascularized by collaterals were studied by arteriography in adult rabbits. Amputation on the crus immediately after ligature of the femoral artery caused a retardation in the development of collaterals and a protracted vasoconstriction in the amputation stump. Osseous plugging of the medullary cavity in the amputation stump counteracted the vasoconstriction, and the development of collaterals was improved. When amputation on the crus was performed 3-6 days after ligature of the femoral artery, immediate function of the collaterals and a rapid dilatation of the arteries in the below knee amputation stump were seen, and 3--4 weeks postoperatively arteriovenous shunts developed in the stump. Amputation 7--10 weeks after ligature of the artery involved a more pronounced shunt development in the amputation stump. After amputation on the femur only slight differences were observed in the development of collaterals and the vascularization in the amputation stump compared with findings after amputation on the crus.

Amputation, Surgical↗
PubMedDate not supplied

Tissue-engineered skin in the healing of wound stumps from limb amputations secondary to purpura fulminans.

Currently wound treatment options of amputation stumps due to purpura fulminans include healing by secondary intention from wound debridement, split-thickness skin grafting, tissue and muscle flaps, plantar skin free transfer, skin expansion, artificial skin, and hyperbaric oxygen therapy. We saw a 6-month-old girl with purpura fulminans as a complication of meningococcemia. She developed necrosis of the distal extremities resulting in bilateral amputation of the lower limbs. Shortly thereafter the leg stumps also became necrosed and she underwent unsuccessful split-thickness grafts of lower limb ulcers. The patient's difficult-to-heal wounds made her an excellent candidate for treatment with tissue-engineered skin. At 10 months of age, this was applied to her previously nonhealing wounds. The tissue-engineered skin induced rapid healing of the patient's chronic amputation stump ulcers and provided her with substantial pain relief. In conclusion, tissue-engineered skin appears to be a potential beneficial treatment for chronic wounds in children with nonhealing amputation stumps.

Amputation, Surgical↗