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Wheeless' Textbook of Orthopaedics

Amputation Menu



      - Amputations in the Diabetic Patient
      - Above the Knee Amputation:
              - AKA prosthetics
      - Below Knee Amputation:
              - amputation following fractures of the tibia
              - pediatric BKA:
              - BKA prosthetics
                     - prosthetic feet
      - Foot and Ankle Amputation
              - Syme's Amputation
              - Transmetatarsal Amputation
              - Chopart Amputations
      - Pediatric Amputations
      - Upper Extremity Amputations:
              - amputation of the finger and hand:
              - above-elbow amputation
              - below-elbow amputation
              - upper extremity prosthetics:
              - wrist disarticulations 





- Mangled Extremity Scoring:
      - references:
           - Amputations and Artificial Limbs--Symposium: Limb Salvage Versus Amputation: Preliminary Results of the Mangled Extremity Severity Score.
           - The Severely Traumatized Lower Limb: Reconstruction versus Amputation--Symposium: Vascular Injury Associated With Fracture-Dislocations of the Lower Extremity.



- Links:
    - Civil War Medicine



Wound Healing and Basic Science References:
   - Outcome in 282 lower extremity amputations. Knee salvage and survival.
   - A multivariate analysis of determinants of wound healing in patients after amputation for peripheral vascular disease.
   - The role of non-invasive vascular studies in determining levels of amputation.
   - The role of non-invasive vascular studies in determining levels of amputation.
   - Doppler-determined segmental pressures and wound-healing in amputations for vascular disease.
   - Prediction of amputation wound healing. Roles of Doppler ultrasound and digit photoplethysmography.
   - The blood supply to the skin of the leg: a post-mortem investigation.
   - The assessment of skin viability using fluorescein angiography prior to amputation.
   - Transcutaneous oxygen and carbon dioxide pressure monitoring to determine severity of limb ischemia and to predict surgical outcome.
   - Prospective comparison of noninvasive techniques for amputation level selection.
   - Muscle blood flow after amputation with special reference to the influence of the amputation level. Assessed by 133 xenon and histamine. An animal experiment.
   - Segmental transcutaneous measurements of PO2 in patients requiring below-the-knee amputation for peripheral vascular insufficiency.
   - The assessment of skin viability using fluorescein angiography prior to amputation.
   - Predictive value of distal perfusion pressure in the healing of amputation of the digits and the forefoot.
   - Transcutaneous oxygen tension measurement in peripheral vascular disease.
   - Oxygen-derived free radicals in postischemic tissue injury.
   - Arterial systolic pressures in critical ischemia.
   - Dry ice cryoamputation: a twelve-year experience.
   - Improvement of amputation level by lower extremity revascularization.
   - Level selection in leg amputation for arterial occlusive disease: a comparison of clinical evaluation and skin perfusion pressure.
   - Salvage of a functional lower limb in diabetic patients after amputation.  Jacobs RL. Instructional Course Lectures. 42:159-67, 1993.
   - Surgical techniques for conserving tissue and function in lower-limb amputation for trauma, infection, and vascular disease.
   - Risk factors for failed healing in amputation for vascular disease. A prospective, consecutive study of 177 cases.
   - Improvement of amputation level by lower extremity revascularization.



- Reduction of Infection in Amputations:
    - Prophylactic antibiotics in amputation of the lower extremity for ischemia. A placebo-controlled, randomized trial of cefoxitin.
    - Reduction in amputation stump infection by antiseptic pre-operative preparation.
    - Prophylactic antibiotics in amputation of the lower extremity for ischemia. A placebo-controlled, randomized trial of cefoxitin.
    - Lower extremity amputation: open versus closed.
    - Short-term cefotaxime prophylaxis reduces the failure rate in lower limb amputations [published erratum appears in Acta Orthop Scand 1991 Oct;62(5):509.



- Innovative Ideas and Techniques:
     - A new operation for the prevention and treatment of amputation neuromas.
     - A new technique of open amputation: use of the rolled flap.
     - A 50-cm fillet flap for preservation of maximal lower extremity residual limb length.
     - Heterotopic Ossification Following Traumatic and Combat-Related Amputations




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Sunday, August 30, 2009 11:14 am