Lecture-2 Practical

Mrs. Nidaa Alanazi
Out line:
•Levels of amputations.
•Postoperative Care.
Stump Definition:
• STUMP: Is the distal end of a limb left after AMPUTATION.
• AMPUTATION: is the removal of a body extremity by
trauma or surgery.
• A limb may be amputated or missing because of:
1. blood vessel disorder (eg; atherosclerosis, damage due
to diabetes, gangrene)
2. Cancer (malignant tumors)
3. Massive trauma ( eg; in a motor vehicle accident),
4. Birth defect.
Levels of amputation for UE & LE:
Postoperative Care
• Maintain function in the remaining leg and stump to maintain
peripheral circulation.
• Maintain respiratory function.
Stump care
• Hygiene and skin care.
• elevation to reduce swelling
• Stump bandaging is done to preventing hematoma and
• Swelling must be prevented to allow proper attachment of
the Prosthesis, and the prevention of Pressure sores.
• The stump sock is put on first, then the prosthesis
• The prosthesis must be cleaned and maintained.
Immediate Postoperative
Prosthetic Fitting (IPOPF).
A temporary prosthesis was applied in operating room at the conclusion of
Advantage of IPOPF:
• Reduces pain and edema.
• Prevents muscular atrophy.
• Prevents contracture.
• Provides good motivation.
• Prevention of infection.
• Reduces chances of
phantom pain.
• Speeds up rehabilitation.
Disadvantage of IPOPF:
• Delayed wound healing.
Preprosthetic Training
Active ROM ex’s.
Proper positioning of the stump.
Muscle strength.
Skin care.
Crutch training.
Wheel chair mobility.
Self care.
Patient and family education.
Prosthetic Training
• Thus done through collaboration among physiotherapist,
occupational therapist, prosthetist.
• This phase includes:
• Prosthetic fitting: including alignment check, pressure point relief,
• Donning and doffing training: for independence in care
• Skin care training: to avoid pressure ulcers, skin infections.
• Gait training: includes weight bearing, weight transfers, stepping
training, walking with or without assistive aids, stair climbing, etc.
• Maintenance of prosthesis.
• Patient starts touch down weight bearing within 24-48 hours
after surgery.
• Gradually weight bearing is increased with training in parallel
bar and then with crutch and walkers.
Thank You ..