limb deformity and amputation

8/17/2019 Limb Deformity and Amputation

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Limb Deformity and Amputation


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Limb DeformityCongenital

• Complete/partial absence of a

limb• Overgrowth or undergrowth of

a limb (polydactyly, syndactylyor Apert syndrome, Marfansyndrome)

• Constriction band syndrome(entrapment of foetal parts byfibrous amniotic bands whilstin utero)

• Amniotic fluid band syndrome

• Achondroplasia (mostcommon cause of dwarfism)

• Osteogenesis imperfecta

(genetic mutationcharacteried by abnormalcollagen formation resulting inmultiple fractures anddeformity)


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Limb Deformity Acquired

• !ic"ets

• #rauma

• Meningitis

• $oliomyelitis


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Congenital Limb Deformity• Can be caused by a genetic abnormality,

medication or intrauterine growth restriction

• Most prominent e%ample is thalidomide& #reated morning sic"ness, resulted in limbdeformities


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Acquired Limb Deformity• $olio

& Can cause temporaryparalysis

& $aralytic polio causes

deformities in the hips, an"lesand feet

• !ic"ets'

& Osteomalacia in children,

caused my vit deficiency & ones are wea"

& *eads to s"eletal deformities


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Limb Amputation• #he surgical removal of part of the body, it can be a whole limb,

or part of a limb

• +ome of the reasons for amputation are& gangrene, as a conse-uence of $.

& serious trauma to the limb

& serious infection, to protect the rest of the body

• Outloo" for patients following amputation depends on severalfactors&

age wal"ing with a prosthesis is more physically demanding& how much of the limb was removed

& how well they cope with the emotional and psychological impactof amputation

• 0ollowing amputation, people have reported feelings of grief

and loss very similar to mourning


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1pper limb amputation is lesscommon than lower limb2 3t isoften as a result of seriousin4ury2

*ower limb amputation ismore common, especially inthe elderly2 #hese tend to beas a result of $. or diabetes2


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Phantom Limb Pain• 0ollowing amputation, a person may still have sensations from

the missing limb, it can 4ust be an awareness or it can be painful2

• 3t can be described as 5burning, aching, as if the hand is beingcrushed in a vice6

• #hree potential mechanisms'& #he peripheral theory suggests that pain may be the result of nerve

endings around the stump forming into neuromas2 #hese thengenerate abnormal impulses which can be interpreted as pain2

& #he spinal theory suggests that the lac" of sensory input leads to

changes in the C7+2 #his leads to 8confusion8 in certain regions ofthe brain, triggering symptoms of pain2

& #he central theory proposes that the brain has a 8memory8 of theamputated limb and its associated nerve signals, including pain2


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Prostheses

• $rosthetic limbs are not suitable for everyone, a purelycosmetic limb may be recommended instead2

• 3f offered a prosthetic limb, patients undergo a seriesof activites prior to discharge'& esensitisation, to ma"e the prosthetic more

comfortable, it consists of the followin steps' gently tapping the s"in with a face cloth

using compression bandages to help reduce swelling

rubbing and pulling the s"in around the bone to minimisescarring

• $atients will also undergo physiotherapy to strengthenthe remaining muscles


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Prosthetic Legs


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Treating Phantom Limb Pain• !esearch carried out in *iverpool in 9::; found

that if people spent time imagining stretchingout their missing limb this would reduce their

pain2• A similar techni-ue that can be used is "nown as

mirror visual feedbac"2& a mirror is used to create a reflection of the other

limb2 $eople then move/massage their remaininglimb and this can relieve pain2

• +ometimes analgesics are used or non


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Living with Limb deformity or amputation

• Medical, social models

• $sychological model different activitylimitations because of their cognitions,emotions, or coping strategies2

• +tereotyping

• +tigma (felt or enacted)• epression

• =%clusion, isolation


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Living with limb deformity or amputation

• Adaptations home, environment

• athing, washing, personal hygiene

• 7ourishment

• ressing tree adaptive donning and doffingtechin-ues


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limb deformity and amputation

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