Skin problems of the leg amputee

Levy, S. William

doi:10.3109/03093648009103113

Cited by 75 publications

(27 citation statements)

References 3 publications

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“…Confinement of the stump in the socket and friction can cause skin maceration leading to folliculitis, eczema, or mycosis. Epidermoid cysts may develop in the subcutaneous tissue as a consequence of the implantation of keratin islets during surgery (26,29). Aggressive bone edge and heterotopic ossification may lead to ulceration.…”

Section: Cutaneous Lesionsmentioning

confidence: 99%

Imaging of the Painful Lower Limb Stump

Henrot¹,

Stines²,

Walter³

et al. 2000

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102

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Several postoperative complications associated with pain may develop in the stump of an amputated lower limb. Clinical findings are often nonspecific; however, radiologic evaluation, especially with magnetic resonance (MR) imaging, is useful in the early diagnosis of these complications, thereby helping minimize physical disability with its psychologic and socioeconomic implications. Conventional radiography can demonstrate evidence of osseous origins of pain (eg, aggressive bone edge, heterotopic ossification, osteomyelitis) and should be the first imaging study performed after clinical examination. Videofluoroscopy can help evaluate improper prosthetic fit by demonstrating abnormal residual limb motion, piston action, rolling of soft tissues, and abnormal angle between the limb axis and the prosthesis during gait. Ultrasonography can demonstrate inflammatory changes in the stump as well as soft-tissue fluid collections. However, MR imaging is the modality of choice when clinical and other imaging findings are indeterminate. Because of its high spatial and contrast resolution, MR imaging can demonstrate subtle inflammatory changes, fluid collections, cancers, neuromas, and subtle traumatic bone lesions. Knowledge of various surgical and rehabilitation techniques is required for accurate diagnosis of complications associated with stump pain. Correct diagnosis allows choice of the most appropriate therapy, which may involve treating the stump, remodeling the prosthesis, or both.

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Section: Cutaneous Lesionsmentioning

confidence: 99%

Imaging of the Painful Lower Limb Stump

Henrot¹,

Stines²,

Walter³

et al. 2000

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102

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“…Suitable pressure distribution within the lower-limb prosthetic socket is important for the comfort and function of the amputee [ 1 – 3 ], and an adequately fitting socket is required for extensive use of a functional prosthesis [ 4 ]. Inappropriate sockets have been implicated in cases of dermatological issues [ 5 , 6 ] and pressure injury [ 7 , 8 ]. Furthermore, socket comfort and socket fit are widely cited by users as the most important factor in their satisfaction with a prosthetic lower limb [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Studies Examining Transtibial Prosthetic Socket Pressures with Changes in Device Alignment

et al. 2017

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Suitable lower-limb prosthetic sockets must provide an adequate distribution of the pressures created from standing and ambulation. A systematic search for articles reporting socket pressure changes in response to device alignment perturbation was carried out, identifying 11 studies. These were then evaluated using the American Academy of Orthotists and Prosthetists guidelines for a state-of-the-science review. Each study used a design where participants acted as their own controls. Results were available for 52 individuals and five forms of alignment perturbation. Four studies were rated as having moderate internal and external validity, the remainder were considered to have low validity. Significant limitations in study design, reporting quality and in representation of results and the suitability of calculations of statistical significance were evident across articles. Despite the high inhomogeneity of study designs, moderate evidence supports repeatable changes in pressure distribution for specific induced changes in component alignment. However, there also appears to be a significant individual component to alignment responses. Future studies should aim to include greater detail in the presentation of results to better support later meta-analyses.

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“…If pressure, suction or infection is not the causative agent of damage it might be hypersensitivity reactions to materials simply labelled eczema. These different categories of skin lesions of stumps have been especially dealt with by Levy (1980). We found that scar problems were common during the early period and the other skin problems increased with time ( Table 1).…”

Section: Discussionmentioning

confidence: 91%