Approach

• Expose legs from groin to toes
• Patient may be placed on chair

1. Look
   • Amputation stump / stump health 
   • Anatomical level of amputation (12 cm above knee, 14cm below knee)
   • AKA: Equal anterior-posterior flaps
   • BKA: long posterior Burgess gastrocnemius flap
   • BKA: skew flap of Kingsley Robinson
2. Feel
   • Soft tissue should move freely
3. Move
   • Flex / extend joint
   • Attach prosthesis

Completion

1.  Examine rest of limb
2. Peripheral vascular examination

Indications for amputation

1. Vascular: PVD, AV fistulae
2. Infection: osteomyelitis, gangrene, necrotizing fascitis
3. Trauma
4. Malignancy

Complications of amputation

1. Early
   • Psychological / social problems
   • Haematoma
   • Wound infection
   • DVT / PE
   • Phantom limb pain
   • Skin necrosis
2. Late
   • Osteomyelitis - infection transmitted through stump
   • Stump ulceration
   • Stump neuroma
   • Flexion deformity
   • Difficulty mobilising
   • Spurs / osteophytes

[Amputations]