Implement TMR with Your Patients and Improve Their Quality of LifeDeveloped by Dr. Todd A. Kuiken and Dr. Gregory A. Dumanian, targeted muscle reinnervation (TMR) is a new approach to accessing motor control signals from peripheral nerves after amputation and providing sensory feedback to prosthesis users. This practical approach has many advantage
Part of the best-selling Operative Techniques series, Operative Techniques in Plastic Surgery provides superbly illustrated, authoritative guidance on operative techniques along with a thorough understanding of how to select the best procedure, how to avoid complications and what outcomes to expect. This stand-alone book offers focused, easy-to-follow coverage of lower limb reconstruction and amputation, all taken directly from the larger text. It covers nearly all plastic surgery operations for these specific areas that are in current use, and is ideal for residents and physicians in daily practice.
The primary initial effort in every case of disease or injury should be to save the extremity. Amputation is seldom necessary following bone and joint injuries. More often, it is an admission of defeat in the medical management of the patient with vascular disease. In such cases, it should be performed only as a last resort. The longest possible lever arm, consistent with primary healing, should be maintained for maximum proprioceptive and kinesthetic feedback and thus rehabilitation potential.
This volume provides a concise and up to date resource that directly addresses the needs of general surgeons who perform vascular surgery by focusing on the diagnosis and clinical management of common vascular conditions. The volume is divided into sections on arterial disease, venous disease, vascular trauma, and vascular access. Chapters on arterial disease outline the management and surgical techniques for the treatment of acute limb ischemia, compartment syndrome, and diabetic foot infections. Chronic arterial disease is addressed in chapters devoted to the management of claudication, critical limb ischemia, and lower extremity amputation. The section on vascular trauma emphasizes surgical intervention for blood vessel injuries that occur in the neck, abdomen, and extremity. Vascular access chapters deal with the technical aspects and potential complications of temporary venous access catheters and permanent arteriovenous access for hemodialysis. More complex vascular topics are also covered with chapters that are shorter in length and focused on the diagnosis and a broad understanding of treatment options. Essentials of Vascular Surgery for the General Surgeon is the first of its kind to accurately mirror the SCORE curriculum for vascular disease as a patient care topic in general surgery training, acting as a “one stop” information source that general surgery trainees can turn to as a clinical reference and as a study guide for general surgery in service exams and board.
The main objective in the rehabilitation of people following amputation is to restore or improve their functioning, which includes their return to work. Full-time employment leads to beneficial health effects and being healthy leads to increased chances of full-time employment (Ross and Mirowskay 1995). Employment of disabled people enhances their self-esteem and reduces social isolation (Dougherty 1999). The importance of returning to work for people following amputation the- fore has to be considered. Perhaps the first article about reemployment and problems people may have at work after amputation was published in 1955 (Boynton 1955). In later years, there have been sporadic studies on this topic. Greater interest and more studies about returning to work and problems people have at work following amputation arose in the 1990s and has continued in recent years (Burger and Marinc ?ek 2007). These studies were conducted in different countries on all the five continents, the greatest number being carried out in Europe, mainly in the Netherlands and the UK (Burger and Marinc ?ek 2007). Owing to the different functions of our lower and upper limbs, people with lower limb amputations have different activity limitations and participation restrictions compared to people with upper limb amputations. Both have problems with driving and carrying objects. People with lower limb amputations also have problems standing, walking, running, kicking, turning and stamping, whereas people with upper limb amputations have problems grasping, lifting, pushing, pulling, writing, typing, and pounding (Giridhar et al. 2001).
The majority of amputations in the western world today are due to vascular disease. Despite the advances in surgical treatment of this disease, particularly by reconstruction, it is a sad fact that the number of amputations performed in these countries each year for vascular disease is increasing. Most of these amputees are elderly and their life expectancy is short, so it is important that the treatment and rehabilitation that they receive is informed, appropriate, efficient and swift to enable them to return successfully to life in the community for their remaining years. Management of this group of patients has proved to be successful only if a multidisciplinary team approach is adopted. Until recently in the UK, this approach sadly has only been implemented by a few centres. However, with the publication of the McColl report into the prosthetic and wheelchair service in 1986, interest in the care of the amputee is growing throughout the country. This book covers all aspects of amputation from disease and diagnosis to rehabilitation and community discharge with emphasis on the man agerneut of the largest group, the vascular lower limb amputee. A team approach is described and emphasized as being essential for good results and subsequent successful return into the community. The role of each of the important disciplines is described in relation to the appropriate part of the rehabilitation phase.
This resource addresses all aspects of combat amputee care ranging from surgical techniques to long-term care, polytrauma and comorbidities such as traumatic brain injury and burns, pain management, psychological issues, physical and occupational therapy, VA benefits, prosthetics and adaptive technologies, sports and recreational opportunities, and return to duty and vocational rehabilitation.
Prosthetic Restoration and Rehabilitation of the Upper and Lower Extremity is a well-illustrated, state-of-the-art reference on the science and practice of post-amputation care, prosthetic restoration, and functional rehabilitation, designed to maximize patient independence and quality of life. Chapters are written by physiatrists, prosthetists, surgeons, and therapists at the University of Michigan, clinicians and teachers who work with amputees on a daily basis. Clinically oriented, it covers both lower and upper extremity restoration and rehabilitation and serves as a handy reference for busy practitioners to support sound clinical decision-making. Beginning with basic anatomy, kinesiology, and a recap of surgical decisions principles and post-operative care for amputees, the book discusses biomechanics, clinical assessment, prosthetic options, how to write a complete and detailed prescription for the prosthesis, restoration and management of specific problems by region, and rehabilitation programs and strategies. Common medical issues such as phantom limb sensation and pain, skin problems, and sexual and psychological considerations are discussed as well. In-depth coverage of prosthetic restoration is provided for special populations such as infants, children, the elderly, athletes multi-extremity amputees, and those who have lost limbs to cancer. Chapters are written in expanded outline format for ease of use and feature numerous full-color diagrams, photos, and other illustrations. This text will guide physicians, trainees, and other members of the care team through the fundamentals of restoring function to individuals who have lost limbs or body parts. Key Features: Provides a state-of-the-art, accessible, clinical approach to post-amputation care, prosthetic restoration, and functional rehabilitation Covers both upper and lower extremities Addresses prostheses for special populations and sports and recreation Includes boxed clinical pearls at the start of each chapter, illustrated quick reference tables, and full-color photos throughout Supports clinical decision making and addresses practical questions and problems Advises on new requirements for Medicare and Medicaid patients, and includes patient education materials and sample prescription forms that can be customized for use in any clinic Outlines important information for returning to the community after amputation
"This text serves as a comprehensive guide for the care of patients requiring lower extremity major amputations. It details the indications, technicalities and procedural steps, risks and benefits to above-knee, below-knee and through-knee amputations. The textbook also details aspects regarding quality of amputation care, epidemiology of this disease and psychiatric considerations when managing patients with lower extremity amputation"--
