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Fundamentals of Amputation Care and Prosthetics m Fundamentals oF amputation Care urphy and prosthetiCs Fundamentals o Fundamentals douglas murphy, MD ritten by experienced physiatrists, prosthetists, and therapists, this book pro- Wvides an introduction to the field of amputee care and prosthetics. Dedicated oF amputation chapters guide you through prescription of prostheses for the various levels and types of amputations in both the lower and upper extremity and address recent F advances in functionality and safety. Pre- and post-operative care, prosthetic a mputation Care and troubleshooting, gait issues and medical management of the residual limb are also addressed. With concise key information highlighted throughout, this hand- Care book is a welcome point of care resource or study tool for trainees and practitio- ners in any field who work with amputees to restore function and help enrich the lives of these individuals. Fundamentals of Amputation Care and Prosthetics features: and • Concise, practical manual; covers the basics of upper and lower extremity amputee care and prosthetics • Succinct presentation, well-illustrated; information is easy to find p Portable; perfect for use on rounds or in the clinic • rostheti • State-of-the-art distillation of current thinking and practice; excellent transitional book for residents or ready reference for experienced prosthetiCs practitioners C s Recommended Shelving Category: Physical Medicine & Rehabilitation ISBN 978-1-9362-8770-3 douglas murphy 11 W. 42nd Street New York, NY 10036-8002 www.demosmedpub.com 9 781936 287703 Fundamentals of Amputation Care and Prosthetics (021)66485438 66485457 www.ketabpezeshki.com (021)66485438 66485457 www.ketabpezeshki.com Fundamentals of Amputation Care and Prosthetics Editor Douglas Murphy, MD Associate Professor of Physical Medicine and Rehabilitation Virginia Commonwealth University Staff Physician Hunter Holmes McGuire VA Medical Center Richmond, Virginia New York (021)66485438 66485457 www.ketabpezeshki.com Visit our website at www.demosmedpub.com ISBN: 9781936287703 e-book ISBN: 9781617051197 Acquisitions Editor: Beth Barry Compositor: Exeter Premedia Services Private Ltd. © 2014 Demos Medical Publishing, LLC. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or trans- mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Medicine is an ever-changing science. Research and clinical experience are continually expanding our knowledge, in particular our understanding of proper treatment and drug therapy. The authors, editors, and publisher have made every effort to ensure that all information in this book is in accordance with the state of knowledge at the time of production of the book. Nevertheless, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the contents of the publication. Every reader should examine carefully the package inserts accompanying each drug and should carefully check whether the dosage sched- ules mentioned therein or the contraindications stated by the manufacturer differ from the statements made in this book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Library of Congress Cataloging-in-Publication Data Fundamentals of amputation care and prosthetics / [edited by] Douglas Murphy. p. ; cm. Includes bibliographical references and index. ISBN 978-1-936287-70-3—ISBN 978-1-61705-119-7 (e-book) I. Murphy, Douglas (Douglas P.), editor of compilation. [DNLM: 1. Amputation. 2. Artificial Limbs. WE 170] RD553 617.5'8059—dc23 2013020149 Special discounts on bulk quantities of Demos Medical Publishing books are available to corporations, professional associations, pharmaceutical companies, health care organizations, and other qualifying groups. For details, please contact: Special Sales Department Demos Medical Publishing, LLC 11 West 42nd Street, 15th Floor New York, NY 10036 Phone: 800-532-8663 or 212-683-0072 Fax: 212-941-7842 E-mail: [email protected] Printed in the United States of America by Gasch Printing.. 13 14 15 16 17 / 5 4 3 2 1 (021)66485438 66485457 www.ketabpezeshki.com Dedicated to David X. Cifu, MD and the Amputation System of Care for their exemplary and selfless service to veterans across the nation. (021)66485438 66485457 www.ketabpezeshki.com (021)66485438 66485457 www.ketabpezeshki.com Contents Contributors ix Preface xi Acknowledgments xiii 1. History of Amputation: From the Past to the Present 1 Shane McNamee 2. Physical Exam 7 Shane McNamee 3. Levels of Amputation 15 Douglas Murphy 4. Pre- and Post-Operative Care: Readiness for Fitting 23 Christie J. Wamsley 5. Rehab Post Surgery 36 Mary Elizabeth C. Ryan and Patty Young 6. Definitive or “Permanent” Prosthesis 43 John Fox 7. Lower Extremity Prosthetic Componentry 49 Shaun O’Brien 8. Partial Foot Amputation 59 Joseph Webster 9. The Symes Amputation and Prosthetic Options 70 Terry L. Kalter vii (021)66485438 66485457 www.ketabpezeshki.com viii Contents 10. Transtibial Amputations 77 Patty Young 11. Knee Disarticulation Prosthesis Criteria 86 John Fox 12. Transfemoral Prosthetic Prescription 91 Patty Young 13. Hip Disarticulation, Hemipelvectomy Amputation, and Prostheses 101 Terry L. Kalter 14. Prosthetic Considerations for Patients With Partial Hand Amputation 108 Allison Hickman 15. Prosthetic Prescriptions for Long Transradial Amputations 119 Christopher Fantini 16. Prosthetic Prescriptions for Short Transradial Amputations 149 Christopher Fantini 17. Prosthetic Prescriptions for Transhumeral Amputations 164 Christopher Fantini 18. Shoulder Disarticulation and Forequarter Amputation 177 Allison Hickman 19. Normal Human Gait 189 Joseph Webster 20. Gait Deviations After Limb Loss 202 Leif Nelson 21. Medical Management of the Residual Limb 215 Douglas Murphy Index 225 (021)66485438 66485457 www.ketabpezeshki.com Contributors Christopher Fantini, MSPT, CP, BOCO Lead Clinical/Research Prosthetist, Department of Veterans Affairs, Prosthetics and Sensory Aids Services, NY VA Medical Center, New York, New York John Fox, CPO Supervisor of Orthotics and Prosthetics Services, Prosthetic Treatment Center, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia Allison Hickman, DO Polytrauma and Amputee Fellow, Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia Terry L. Kalter, MS, CP, BOCO, LPO Chief, Prosthetic Clinical Services VISN 3, Department of Veteran’s Affairs, NY Harbor Healthcare Systems, New York, New York Shane McNamee, MD Chief, Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, U.S. Department of Veterans Affairs; Assistant Professor, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia Douglas Murphy, MD Associate Professor, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University; Staff Physician, Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia ix (021)66485438 66485457 www.ketabpezeshki.com x Contributors Leif Nelson, PT, DPT, ATP, CSCS Clinical Coordinator, Prosthetics and Sensory Aids Service, VA NY/NJ Healthcare System; Associate Professor, Doctor of Physical Therapy Program, Touro College, School of Health Sciences, New York, New York Shaun O’Brien, CPO Chief of Prosthetic and Sensory Aids, Richard L. Roudebush VA Medical Center, Member of American College of Healthcare Executives, ACHE, Indianapolis, Indiana Mary Elizabeth C. Ryan, MSPT Clinical Specialist, Physical Therapist, Department of Physical Medicine and Rehabilitation, Kessler Institute for Rehabilitation, Saddle Brook, New Jersey Christie J. Wamsley, PT, CDE Physical Therapist, Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia Joseph Webster, MD Associate Professor, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University; Staff Physician, Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia Patty Young, MSPT, CP Amputee Rehab Coordinator, Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia (021)66485438 66485457 www.ketabpezeshki.com Preface Entering into the world of prosthetics and amputee care can appear daunting and confusing, and finding appropriate reference materi- als to relieve such confusion can often be difficult. Fundamentals of Amputation Care and Prosthetics was conceived and created to facil- itate the transition to a feeling of competence for the resident physi- cian, therapist or practitioner who has little-to-no background in this area. The book is designed to be carried easily within the lab coat for quick reference on issues or questions that may arise. More seasoned practitioners may also find this manual useful to refresh when provid- ing services to amputees in the clinic or therapy setting. Over the past decades the field of prosthetics and amputee care has made enormous gains as advances in technology have been exploited to provide prosthetic components with ever greater func- tionality and safety. Although concise, the book
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