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Amputation

Amputation. Z. Rozkydal. Amputation. Removal of periphery part of the limb at a level of the bone. Obr. 1. Amputation in the calf. Disarticulation. Removal of periphery part of the limb at a level of the joint. Obr. 2. Disarticulation in the knee joint. Indications. Severe ischemia

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Amputation

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  1. Amputation Z. Rozkydal

  2. Amputation Removal of periphery part of the limb at a level of the bone Obr. 1. Amputation in the calf Disarticulation Removal of periphery part of the limb at a level of the joint Obr. 2. Disarticulation in the knee joint

  3. Indications • Severe ischemia • Severe trauma • Infectionwithsepsis • Malignanttumors • Congenitaldiseases • Neuropathiesleading to deeptrophiculcers Obr. 3. deep necrosis in the calf

  4. Preop. assessment Individual access Angiography General condition Occupation Level of amputation- consultation

  5. Technique • Turniquet • Safe surgical approach • Carefull ligating of vessels • Myoplastic surgery • - suture of muscles end to end • Dreinage of the wound • Enough soft tissues • Good skin coverage

  6. Amputation in the foot Phalanx Toes A- Metatarsals- Sharp B- Lisfranc C- Bon-Jäger D- Chopart Level of amputation in the foot

  7. Amputation in the foot and in the ancle Pirogov Syme Boyd

  8. Amputation in the foot and the ancle Amputation in Lisfranc joint Pirogov amputation

  9. Amputation in the foot and the ancle Amputation in Chopart joint Syme amputation

  10. Boyd amputation

  11. Bellow knee amputation 8-15 cm bellow knee joint line

  12. Bellow knee amputation

  13. Above knee amputation In the middle third of the thigh

  14. Above knee amputation

  15. Above knee amputation

  16. Disarticulation of the hip

  17. Hindquarter amputation - hemipelvectomy

  18. Amputation in the hand Phalanx Fingers Metacarpals

  19. Disarticulation in wrist joint

  20. Amputation through forearm

  21. Amputation through arm Amputation in surgical neck Above elbow amputation

  22. Disarticulation in the shoulder

  23. Forequarter amputation Interthoracoscapular amputation

  24. Osteoplastic amputation

  25. Gilotine amputation War surgery One level cut of all structures No suture of the wound Requires reamputation v

  26. Post op. management Elastic bandage to conical shape Positioning Prevention of flexion contracture Proprioception Exercise in bed Verticalisation Walking

  27. The aim Good quality stump Enough soft tissues Strong muscles Ability to walk

  28. Disarticulation in the knee region Skin incision

  29. Joint capsule incision, elevation of the patella

  30. Dissection of posterior joint capsule, section of tibial nerve

  31. Ligation of popliteal vessels, removal of the limb

  32. Suture withount tension Suture of the wound, healed stump

  33. X - ray after disarticulation

  34. Prosthesis after disarticulation of the knee region

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