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Journal of the American Veterinary... Apr 2018OBJECTIVE To characterize indications for and clinical outcomes of limb amputation in goats and sheep. DESIGN Retrospective case series and observational study. ANIMALS...
OBJECTIVE To characterize indications for and clinical outcomes of limb amputation in goats and sheep. DESIGN Retrospective case series and observational study. ANIMALS Goats (n = 15) and sheep (7) that underwent partial or complete limb amputation at the University of California-Davis Veterinary Medical Teaching Hospital from January 1, 1985, through December 31, 2015. PROCEDURES Medical records of qualifying goats and sheep were reviewed and data extracted regarding signalment, use of animal, characteristics of the amputated limb, duration of hospitalization, outcome, and surgery-associated complications. The Fisher exact test was performed to compare postsurgical complication rates between various groups. RESULTS Reasons for limb amputation included trauma (ie, fracture, dog bite, and wire-fence injury) and infectious or degenerative disease (ie, osteomyelitis and osteoarthritis). Median (range) hospitalization period for goats and sheep was 7.5 days (1 to 63 days) and 8 days (3 to 20 days), respectively. Most (7/9) of the postsurgical complications were noticed > 2 months after amputation and included uncoordinated gait, tendon breakdown and laxity of the contralateral limb, chronic lameness, surgical site infection, chronic intermittent pain, and angular limb deformity. No association was identified between postsurgical complication rate in goats and body weight category (< 20 vs ≥ 20 kg [44 lb]), age category (< 2 vs ≥ 2 years), and amputated limb type (forelimb vs hind limb). CONCLUSIONS AND CLINICAL RELEVANCE Clinical outcomes for goats and sheep following limb amputation varied and were seemingly case dependent. Amputation should be considered when preservation of the whole limb is not possible. Veterinarians should advise owners that limb amputation may result in various complications and recommend aftercare treatment such as physiotherapy.
Topics: Amputation, Surgical; Animals; California; Female; Goat Diseases; Goats; Leg Injuries; Male; Osteomyelitis; Outcome Assessment, Health Care; Postoperative Complications; Retrospective Studies; Sheep; Sheep Diseases
PubMed: 29553907
DOI: 10.2460/javma.252.7.860 -
Clinical Orthopaedics and Related... Oct 2014
Topics: Amputation, Surgical; Amputees; Artificial Limbs; Diffusion of Innovation; Humans; Prosthesis Fitting; Prosthesis Implantation; Treatment Outcome
PubMed: 25024030
DOI: 10.1007/s11999-014-3783-7 -
Annals of the Royal College of Surgeons... Jan 1952
Topics: Amputation, Surgical
PubMed: 14895116
DOI: No ID Found -
Medecine Sciences : M/S Oct 2017Since centuries, scientists, clinicians and philosophers have been debating about the interactions between the body and the mind. Researches and advances in... (Review)
Review
Since centuries, scientists, clinicians and philosophers have been debating about the interactions between the body and the mind. Researches and advances in neurophysiology over the last decades have challenged many principles and theories, mainly based on empirical observations, generally well accepted in clinical practice. These new findings, achieved through functional "magnetic resonance imaging", awake brain surgery and allow new techniques and opportunities in physical rehabilitation. More than ever the body and the brain must be considered and treated as a functional entity, the distinction between body and soul developed by Platon should no longer be applied. The development of new technologies, in particular the virtual reality, lends itself perfectly to this global approach. The aim of this article is to present how a purely cognitive training can have beneficial effects on the body and the motor performances in clinics.
Topics: Amputation, Surgical; Amputees; Brain; Cognition; Exercise; Functional Laterality; Humans; Paralysis; Physical Education and Training; Physical Stimulation; Psychophysiology
PubMed: 28994385
DOI: 10.1051/medsci/20173310021 -
Ethiopian Journal of Health Sciences Sep 2023Most amputees suffered from lack of rehabilitation services and went on streets as glorified beggars. However, there is a paucity of information about determinant causes... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Most amputees suffered from lack of rehabilitation services and went on streets as glorified beggars. However, there is a paucity of information about determinant causes of amputation in Ethiopia. Therefore, this systematic review and meta-analysis was conducted to estimate pooled prevalence of limb amputation and its determinant causes in Ethiopian population.
METHODS
Worldwide databases such as PubMed/MedLine, Web of Science, CINAHL, Embase, Scopus, and Science Direct were searched to retrieve pertinent articles. Grey literatures were also looked in local and national repositories. Microsoft excel was used to extract data which were exported to stata version 14.0 for analysis. Cochrane Q and I tests were used to assess heterogeneity. Egger's and Begg's tests were employed to assess reporting biases. Random effect meta-analysis model was applied to estimate pooled prevalence.
RESULTS
Twenty-one qualified studies with 18,900 study participants were reviewed. Pooled prevalence of limb amputation was 31.69%. Lower extremity amputation (LEA) accounted for 14.41%, and upper extremity amputation (UEA) took 10.53% (6.50, 14.53). Above knee amputations (2.50 %) were common orthopedic operations whereas ray amputations (0.03%) were the least orthopedic procedures of LEA. Above elbow amputations (2.46%) were common from UEA while shoulder disarticulations (0.02%) were the least orthopedic surgical procedures. The major causes of limb amputations were trauma (11.05%), diabetic foot ulcer (9.93 %), traditional bone setters (24.10%) and burn (10.63%).
CONCLUSIONS
Lower extremity amputations were common orthopedic surgical procedures. Major determinant causes were trauma, diabetic foot ulcer, traditional bone setters and burn.
Topics: Humans; Ethiopia; Amputation, Surgical; Lower Extremity; Prevalence; Amputees; Upper Extremity
PubMed: 38784515
DOI: 10.4314/ejhs.v33i5.19 -
BMC Musculoskeletal Disorders Nov 2018To review literature on bicycling participation, as well as facilitators and barriers for bicycling in people with a lower limb amputation (LLA). (Review)
Review
BACKGROUND
To review literature on bicycling participation, as well as facilitators and barriers for bicycling in people with a lower limb amputation (LLA).
METHODS
Peer-reviewed, primary, full text, studies about bicycling in people with a LLA from midfoot level to hemipelvectomy were searched in Pubmed, Embase, Cinahl, Cochrane library, and Sportdiscus. No language or publication date restrictions were applied. Included full-text studies were assessed for methodological quality using the Effective Public Health Practice Project tool. Data were extracted, synthesized and reported following Preferred Reporting Items for Systematic Review.
RESULTS
In total, 3144 papers were identified and 14 studies were included. The methodological quality of 13 studies was weak and 1 was moderate. Bicycling participation ranged from 4 to 48%. A shorter time span after LLA and a distal amputation were associated with a higher bicycling participation rate particularly for transportation. In people with a transtibial amputation, a correct prosthetic foot or crank length can reduce pedalling asymmetry during high-intensity bicycling. People with limitations in knee range of motion or skin abrasion can use a hinged crank arm or a low profile prosthetic socket respectively.
CONCLUSION
People with a LLA bicycled for transportation, recreation, sport and physical activity. Adaptation of prosthetic socket, pylon and foot as well as bicycle crank can affect pedalling work and force, range of motion, and aerodynamic drag. Because the suggestions from this review were drawn from evidences mostly associated to competition, prosthetists should carefully adapt the existing knowledge to clients who are recreational bicyclists.
Topics: Amputation, Surgical; Artificial Limbs; Bicycling; Cross-Sectional Studies; Humans; Lower Extremity
PubMed: 30424748
DOI: 10.1186/s12891-018-2313-2 -
International Wound Journal Oct 2022Diabetes-related lower extremity amputations are an enormous burden on global health care and social resources because of the rapid worldwide growth of the diabetic...
Diabetes-related lower extremity amputations are an enormous burden on global health care and social resources because of the rapid worldwide growth of the diabetic population. This research aimed to determine risk factors that predict major amputation and analyse the time interval from first hospitalisation to amputation by using standard management protocols and Kaplan-Meier survival curves. Data from 246 patients with diabetes mellitus and diabetic foot ulcers from the Division of Plastic and Reconstructive Surgery of the Department of Surgery at XXX Hospital between January 2016 and May 2020 were analysed. Univariate and multivariate analyses of 44 potential risk factors, including invasive ulcer depth and C-reactive protein levels, showed statistically significant differences for those at increased risk for major amputation. The median time from hospitalisation to lower extremity amputation was approximately 35 days. Most patients with abnormal C-reactive protein levels and approximately 70% of patients with ulcers invading the bone were at risk for lower extremity amputations within 35 days. Therefore, invasive ulcer depth and C-reactive protein levels are significant risk factors. Other potential risk factors for major amputation and the time intervals from first hospitalisation to amputation should be analysed to establish further prediction strategies.
Topics: Amputation, Surgical; C-Reactive Protein; Diabetes Mellitus; Diabetic Foot; Humans; Lower Extremity; Risk Factors
PubMed: 34879446
DOI: 10.1111/iwj.13727 -
Prilozi (Makedonska Akademija Na... Apr 2022Regenerative peripheral nerve interface (RPNI) is a relatively new surgical technique to manage neuromas and phantom pain after limb amputation. This study evaluates...
Regenerative peripheral nerve interface (RPNI) is a relatively new surgical technique to manage neuromas and phantom pain after limb amputation. This study evaluates prophylactic RPNI efficacy in managing post-amputation pain and neuroma formation in amputees compared with patients in which lower limb amputation was performed without this procedure. We included 28 patients who underwent above the knee amputation (AKA) or below the knee amputation (BKA) for severe soft tissue infection from July 2019 till December 2020. All patients had insulin-dependent diabetes. The patients were divided into two groups, 14 patients with primary RPNI and 14 patients without. We analyzed the demographic data, level of amputation, number of RPNIs, operative time, postoperative complications and functional outcome on the defined follow up period. The mean patient age was 68.6 years (range 49-85), 19 (67.9 %) male and 9 (32.1 %) female patients. In this study 11 (39.3 %) AKA and 17 (60.7 %) BKA were performed. Overall, 37 RPNIs were made. The mean follow-up period was 49 weeks. PROMIS T-score decreased by 15.9 points in favor for the patients with RPNI. The VAS score showed that, in the RPNI group, all 14 patients were without pain compared to the group of patients without RPNI, where the 11 (78.6 %) patients described their pain as severe. Patients with RPNI used prosthesis significantly more (p < 0.005). Data showed significant reduction in pain and high patient satisfaction after amputation with RPNIs. This technique is oriented as to prevent neuroma formation with RPNI surgery, performed at the time of amputation. RPNI surgery did not provoke complications or significant lengthening of operative time and it should be furthermore exploited as a surgical technique.
Topics: Aged; Aged, 80 and over; Amputation, Surgical; Female; Humans; Lower Extremity; Male; Middle Aged; Muscle, Skeletal; Neuroma; Pain; Peripheral Nerves
PubMed: 35451289
DOI: 10.2478/prilozi-2022-0004 -
Pain Practice : the Official Journal of... Feb 2023Among adults with persistent post-amputation pain, increased amputated-region pain sensitivity may reflect peripheral sensitization or indicate underlying central...
OBJECTIVE
Among adults with persistent post-amputation pain, increased amputated-region pain sensitivity may reflect peripheral sensitization or indicate underlying central sensitization. To determine whether underlying central sensitization may contribute to increased pain sensitivity in this population, this study compared clinical signs and symptoms associated with central sensitization between adults with post-amputation pain who demonstrate or lack increased amputated-region sensitivity (as compared to reference data).
DESIGN
Cross-sectional.
SUBJECTS
Ninety-nine adults (60 with a unilateral, transtibial amputation and post-amputation pain, 39 pain-free controls with intact limbs).
METHODS
Participants underwent pain-pressure threshold testing of amputated-region and secondary (non-amputated region) sites and completed outcome measures assessing central sensitization symptoms (Patient-Reported Outcomes Measurement Information System® pain intensity and interference domains, Central Sensitization Inventory). Among the full sample, the presence and frequency of specific central sensitization symptoms were evaluated. Participants with post-amputation pain were then grouped based on whether normalized, amputated-region pain-pressure thresholds fell below (i.e., sensitive) or above (i.e., non-sensitive) the 25th percentile of sex-specific reference data. Between-group differences in normalized secondary-site sensitivity were evaluated using a multivariate analysis of variance; central sensitization symptom scores were compared using a Kruskal-Wallis test.
RESULTS
Noteworthy symptoms associated with central sensitization (e.g., fatigue, sleep disturbance, cognitive difficulty) were reported by 33%-62% of participants. Secondary-site pain sensitivity was greater among individuals with increased amputated-region sensitivity (n = 24) compared to peers without increased amputated-region sensitivity ([n = 36], mean difference > 1.33 standard deviation [SD], p < 0.001). Central sensitization symptom scores, however, were similar between groups (p > 0.187).
CONCLUSIONS
Participants with increased amputated-region sensitivity demonstrate generalized, secondary-site pain hypersensitivity, potentially indicating underlying central sensitization. Central sensitization symptom scores, however, were similar between groups, suggesting differences in physiological pain sensitivity may not manifest in subjective post-amputation pain descriptions.
Topics: Male; Female; Adult; Humans; Cross-Sectional Studies; Pain; Pain Threshold; Amputation, Surgical; Pain Measurement; Central Nervous System Sensitization
PubMed: 36250812
DOI: 10.1111/papr.13172 -
PloS One 2012Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the...
INTRODUCTION
Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID.
METHODS
Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation) were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared.
RESULTS
Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification.
CONCLUSIONS
The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.
Topics: Adolescent; Amputation, Surgical; Body Dysmorphic Disorders; Child; Child, Preschool; Data Collection; Female; Humans; Male
PubMed: 22514657
DOI: 10.1371/journal.pone.0034702