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Amputations
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Heledd Havard, William Aston, Rob Pollock
When considering performing a hip disarticulation or hindquarter amputation, all patients should receive preoperative support including consultation with a psychologist, specialised amputee physiotherapist and prosthetist. The majority of patients will not progress to a prosthetic and the consequences of surgery will have a significant impact on their day-to-day living circumstances, with some unable to return to their home.
Poultry and Eggs
Published in Christopher Cumo, Ancestral Diets and Nutrition, 2020
The aridity that preserved turkey bones and eggshells in the Southwest likewise perpetuated human remains. To be sure, conditions were imperfect. The extent of disarticulation complicated the tasks of reassembly and examination.145 Coyotes (Canis latrans), foxes (Vulpes macrotis and Urocyoncinereoargenteus), bobcats (Lynx rufus), cougars (Puma concolor), or their combination worsened disorder by attempting to eat corpses, scattering bones in the process.146 Amerindians contributed to disarray by reentering burial chambers over several generations, repositioning old remains to accommodate new ones.147
Drowning
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
A recent study stressed the difficulties in evaluating time since death in water based on late PM decomposition changes [24]. During the course of skeletonization, joint disarticulation is enhanced by marine and fluvial currents and movement of the corpse in water during drifting. Disarticulation occurs first distally in the limbs due to higher torsion forces, while sinovial joints such as the shoulder are disconnected before the fibrous intervertebral ones. Studies on waterborne cadavers show a disarticulation sequence starting from the bones of the hands and wrists followed by bones of the ankles, mandible, cranium, legs and arms. Often the most buoyant disarticulated portion is a foot enclosed in a shoe that on occasion is found on a beach and traced to a drowning victim [85].
The effect of microprocessor controlled exo-prosthetic knees on limited community ambulators: systematic review and meta-analysis
Published in Disability and Rehabilitation, 2022
Andreas Hahn, Simon Bueschges, Melanie Prager, Andreas Kannenberg
Randomized or non-randomized comparative study that compared the outcomes with use of one or more MPKs to those with one or more NMPKs.Study with results for subjects with knee disarticulation or above knee or transfemoral amputation and MFCL-2 or equivalent mobility grade. Limited community ambulators either had to be the primary study group or their results had to be presented as a separate subgroup analysis or as raw data that allowed for a post hoc statistical analysis.Study reported quantitative and comprehensible results of validated outcome measures for safety, function, and mobility with prosthesis use and/or of patient-reported outcomes for perceived safety, function, and satisfaction with the prosthesis.
Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions
Published in Disability and Rehabilitation, 2021
Jette Schack, Peyman Mirtaheri, Harald Steen, Terje Gjøvaag
The characteristics of the study population are presented in Table 1. The mean age (SD) of persons with transtibial amputation was 56 (12) years, and 52 (14) years for persons with transfemoral amputation/knee disarticulation. Most of the amputations had been performed for non-vascular reasons (86%). The mean (SD) number of prescription medications was 1.6 (1.4) for persons with transtibial amputations and 0.9 (1.3) for persons with transfemoral amputation/knee disarticulation. Persons with transtibial amputations were amputated on average (SD) 16 (16) years prior to this investigation, and persons with transfemoral amputation/knee disarticulation on average 22 (18) years prior. All participants wore energy-storing prosthetic feet, and sixteen of the persons with transfemoral amputation used microprocessor-controlled knees, while the others used different types of mechanical knees. The median prosthetic use was 15.5 h/day (range 5–15.5) for persons with transtibial amputation and 14.8 h/day (range: 5–15.5) for persons with transfemoral amputation.
Relation between serum cotinine levels and trophic lesions in patients with critical limb ischemia: a pilot study
Published in Acta Clinica Belgica, 2020
Răzvan A. Ciocan, Cristina-Sorina Cătană, Cristina Drugan, Claudia D. Gherman, Andra Ciocan, Tudor C. Drugan, Sorana D. Bolboacă
Patients with Rutherford grade II (rest pain with ankle pressure <40 mm Hg, toe pressure <30 mmHg), IIIa (rest pain with ankle pressure <60 mmHg, toe pressure <40 mmHg) or IIIb (rest pain with ankle pressure <60 mmHg, toe pressure <40 mmHg), ischemic rest pain, minor or significant tissue loss [13] were included in the study. Patients who were uncooperative or refused to take part in the study were excluded. Demographic characteristics (e.g. gender, age, environment (rural/urban), education), risk factors (e.g. smoking status), and comorbidities (e.g. type 2 diabetes, arterial hypertension, ischemic heart disease, other cardiac diseases or stroke) were recorded for each patient. Signs and symptoms of CLI (e.g. pain, cold skin, hair loss, different pulse values), and interventions such as disarticulation, toe amputation, or necrectomy were also recorded. The data regarding disarticulation, toe amputation, or necrectomy were collected as interventions previously happened or as procedures applied at the current hospitalization.