AMPUTATION

Dr. dr. I Gede Eka Wiratnaya, SpOT (K)

Department of Orthopaedic and Traumatology

Udayana University/Sanglah General Hospital
Denpasar, Bali
WHAT IS AMPUTATION?

The removal of body extremity by trauma,

prolonged constriction or intentional
surgical removal of any body part or limb
for the purpose to remove diseased tissue
or relieve pain.
Important Questions
1. Would survival be affected by the treatment
choice?
2. How do short-term and long-term morbidity
compare?
3. How would the function of a salvaged limb
compare with that of a prosthesis?
4. Are there any psychosocial consequences?
 3 Ds of Amputation

Dead

Damned
Dangerous
nuisance
Determination of Amputation Level
• Increased function (distal amputation) vs decreased
complication rate (proximal amputation)
• Extend of disease
• Healing potential of stump
• Rehabilitation of the patient

UPPER LIMB LOWER LIMB

AMPUTATION AMPUTATION
UPPER LIMB AMPUTATION LEVEL
FOREQUARTER AMPUTATION
TRANSHUMERAL AMPUTATION
DISTAL FOREARM AMPUTATION
WRIST DISARTICULATION
LOWER LIMB
AMPUTATION LEVEL
TRANSFEMORAL (ABOVE-KNEE)
AMPUTATIONS
TRANSTIBIAL (BELOW-KNEE)
AMPUTATIONS
Complications
• Hematoma
• Infection
• Wound necrosis
• Contractures
• Pain
STUMP MANAGEMENT
STUMP SHRINKER
EARLY MANAGEMENT
• Pain management
• Skin disorders and their management
• Psychological consequences of amputation
RESIDUAL
LIMB PAIN
PHANTOM
LIMB PAIN
CURRENT PROSTHETIC OPTIONS

Passive Prosthetic

Body Powered Prosthetic

Lauren Trent, Michelle Intintoli, Pat Prigge, Chris Bollinger, Lisa Smurr
Walters, Dan Conyers, John Miguelez & Tiffany Ryan (2019): A narrative
Body Powered Figure of 8 Harness review: current upper limb prosthetic options and design, Disability and
Rehabilitation: Assistive Technology
Simple Myoelectric Hand

Myoelectric Prosthesis,
Complex Hand

Lauren Trent, Michelle Intintoli, Pat Prigge, Chris Bollinger, Lisa Smurr
Walters, Dan Conyers, John Miguelez & Tiffany Ryan (2019): A narrative
review: current upper limb prosthetic options and design, Disability and
Hybrid Prosthesis Rehabilitation: Assistive Technology
MODULAR SOCKETS
Lower Extremity Prosthetics

Magnetic/flexible pin Perforated gel liner

THANK YOU