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Phantom Sensations (including Phantom Limb Pain)
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Phantom limb pain occurs in 50–80% of limb amputees (Richardson & Kulkarni, 2017). Some amputations occur because of traumatic reasons, such as warfare or car accidents, and some result from nontraumatic disease, like cancer or vascular diseases. Traumatic and nontraumatic amputees are both capable of experiencing phantom pain to a similar degree (Houghton et al., 1994).
Prevalence, Mortality, and Risk Factors
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Diabetic foot complications are among the most disabling of all outcomes. Estimated costs of amputations range between $5,000 and $70,000 based on individual studies in various countries. According to the World Diabetes Foundation, estimated costs for treatment of diabetic foot complications without amputation average nearly $18,000 per patient. Foot complications cause emotional, physical, productivity, and financial losses. Long-term costs include prosthetic devices, special footwear, rehabilitation, and costs related to chronic disability. Costs for home care and social services must also be considered.
RLE Orthopaedic Injury Management
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Jowan Penn-Barwell, Daniel Christopher Allison
In devastating limb injuries for which reconstruction is not advised or possible, a well-performed amputation can set a patient on an early path to functional recovery and rehabilitation. The decision to salvage or amputate a severely injured limb can be challenging, and several scoring systems have been developed to aid in this assessment (Mangled Extremity Severity Score [MESS], Limb Salvage Index [LSI], Predictive Salvage Index [PSI]). Unfortunately, these systems have been proved to be poor predictors of limb viability and function.
Advances in additive manufacturing processes and their use for the fabrication of lower limb prosthetic devices
Published in Expert Review of Medical Devices, 2023
Shaurya Bhatt, Deepak Joshi, Pawan Kumar Rakesh, Anoop Kant Godiyal
Traditionally prostheses are fabricated by assembling various standard components into one assembly that fulfills the required functionality. Some components are made by machining, while some are manufactured using the casting method, which requires a machining process to obtain the finished product. All these processes are not material efficient as raw material is wasted while machining. Moreover, the prostheses fabricated by the traditional method are standard prostheses that are not based on individual requirements and do not provide the utmost fit and comfort to the user. To overcome these shortcomings, the additive manufacturing processes can be used to get the desired fit and comfort as they can provide user-specific outputs. Prosthetic devices are specific to the type of amputation suffered by the person. For example, an above-knee prosthetic limb includes a transfemoral socket, an artificial knee, a pylon, a foot, and a few adaptors to attach these parts into one assembly [43]. A prosthetic device for below-knee amputation would include similar components except for the artificial knee. An above-knee prosthetic device assembly is shown in Figure 3, with components like an artificial knee, a damping device, transfemoral socket, foot, and adaptors. Some of the lower limb prosthesis developed by researchers are given in Figure 4 [3,44–61]. All these devices were developed by traditional methods.
Understanding amputation care in England and Scotland: a qualitative exploration of patient stories posted on an online patient feedback site
Published in Disability and Rehabilitation, 2022
Amputation is a growing health issue within the UK, with particularly high rates among those with diabetes and peripheral arterial disease. In a recent exploration of lower extremity amputations between 1990 and 2017 across 15 countries in the Global North (Global North/Global South is a way of differentiating the world based on political and socio-economic factors, with the Global North referring to the countries of highest wealth and greatest industrialisation), it was found that the UK had the highest percentage increase in amputations among males, and the second-highest increase in females [1]. There is currently a lack of clarity regarding the prevalence of lower limb amputation with rates suggested to be between 5 and 25 per 100,00 of the population [2]. Diabetics are 8–15 times more likely to have a lower limb amputation than the general population and 70% die within five years of surgery [3]. Other amputations arise due to infections including septicaemia (such as resulting from meningitis) or sepsis, or trauma to the limb, (as well as cancers, such as Osteosarcomas and dysphoria around the limb, such as Body Integrity Identity Disorder whereby patients feel like their limb is not part of them and thereby causing intense emotional distress).
Contribution of ankle-brachial index measurement in screening for arteriopathy obliterans of the lower limbs in type 2 diabetics
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2022
Sitraka Angelo Raharinavalona, Rija Eric Raherison, Thierry Razanamparany, Dally Rasoaniana, Radonirina Lazasoa Andrianasolo, Andrinirina Dave Patrick Rakotomalala
Atherosclerosis has become the leading cause of death among diabetics. Indeed, diabetes is an important risk factor for coronary atherosclerosis and peripheral arterial disease, independent of other cardiovascular risk factors. In addition, atherosclerosis in diabetics is more diffuse, more severe and manifests at an earlier age by about 10 years.1 One of the components of the ‘diabetic foot’ with neuropathy and infection, obliterating arteriopathy of the lower limbs (OALL), is the main factor in major amputation in diabetics.2 Amputations are linked to arterial insufficiency in 92% of cases, with diabetes being the cause in 50% of cases. It is estimated that the number of amputees for lower limb arterial insufficiency will increase by 50% by 2030 and 100% by 2050.3 Particularly in Africa, the diabetic foot is responsible for great morbidity and mortality. Its healing is significantly influenced by the presence of arteriopathy.4 Therefore, OALL must be sought and detected systematically and early in diabetics in the same way as other degenerative complications.