Syme Amputation Performed in Two Stages

Spittler, August W.; Brennan, John J.; Payne, John W.

doi:10.2106/00004623-195436010-00005

Cited by 32 publications

(5 citation statements)

References 4 publications

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“…This phase deals with the definitive surgical procedures being done to accomplish bone union, limb length and alignment, and other functional improvements for the salvaged limb. 8,18,35,40,52 Rehabilitation of the patient will be done during this phase. This may include neuromuscular education and edema control in the salvaged limb or prosthetic fitting and gait education after limb amputation.…”

Section: Discussionmentioning

confidence: 99%

“…An anterior flap also is described for patients in whom there is insufficient heel pad. 49,52 Tibia As stated earlier, preservation of bone length is desirable if not at the expense of producing a scarred or insensate stump flap. There is biomechanical value in the longer transtibial amputation.…”

Section: Anklementioning

confidence: 95%

“…Anchoring of the Achilles tendon is mandatory to stabilize the heel pad in place under the tibia. 52 The average shortening of the extremity after this procedure is 10 cm, and weightbearing is possible on the stump end for short distances. An anterior flap also is described for patients in whom there is insufficient heel pad.…”

Section: Anklementioning

confidence: 99%

“…52 The first operation involves the disarticulation of the ankle, with careful sharp subperiosteal dissection to preserve the mechanical integrity of the heel pad. Inadvertent penetration of the fluid-filled compression chambers makes the weightbearing purpose of this flap unusable.…”

Section: Anklementioning

confidence: 99%

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Treatment of the Mangled Lower Extremity after a Terrorist Blast Injury

Langworthy¹,

Smith²,

Gould³

2004

Clinical Orthopaedics and Related Research

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Terrorist bombings, with resultant blast injuries, have been increasing in frequency during the past 30 years. Injury to the musculoskeletal system is common in victims who survive such attacks. Substantial injury to the limbs may occur through several different mechanisms, each of which may affect prognosis and alter the treatment algorithm. An analysis of the available literature on terrorism and blast events revealed that resource use of the treating medical facility is high during the initial hours after a blast attack, but usually is manageable. A resource management protocol was developed to organize the treatment of limb salvage into four phases. This management protocol may improve the medical facility's ability to manage system resources while treating patients with severe blast injuries. The decision of whether to salvage or proceed with limb amputation is one of the most difficult in orthopaedic trauma. A basic education in the mechanisms of blast damage, a methodical approach to resuscitation, and mangled extremity treatment, likely can improve surgical success.

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Section: Discussionmentioning

confidence: 99%

Section: Anklementioning

confidence: 95%

Section: Anklementioning

confidence: 99%

Section: Anklementioning

confidence: 99%

See 2 more Smart Citations

Treatment of the Mangled Lower Extremity after a Terrorist Blast Injury

Langworthy¹,

Smith²,

Gould³

2004

Clinical Orthopaedics and Related Research

View full text Add to dashboard Cite

show abstract

“…Later, a 2-stage procedure was designed, with a first stage used for debridement in case of infection with only loose closure and the second stage for trimming of the malleoli and revision of the skin flap. 50 Several further modifications have been described, for example, a supramalleolar resection 16 or an Achilles tenodesis to prevent heel pad migration. 48…”

mentioning

confidence: 99%