Lower Limb Amputation

Paper Summary:

This paper explains that prosthetic devices were needed the minute the first human was born with a missing or deformed limb, or the first person lost a limb in battle or even during the course of daily life. The author points out that the ancient principles on which prosthetics continue to rely are still amazingly efficient. It explains that in the past 25 years, there have been advances in prosthetic limb technology, such as lightweight plastics, composites and electronic systems; but there will be more, which will continue to open new directions for prosthetics. The paper relates that prostheses for amputations through the hip joint consist of a laminated hip basket, hip joint, knee joint, SACH foot, pipe connectors and external cosmetic finish; an active carbon fiber foot and multi-axis hydraulic and mechanical knee joint may also be used. Charts and illustrations.

Table of Contents
Overview Section
History of Lower Limb Prosthetics
Advancements and the Future
Aetiology and Incidence of Lower Limb Amputation
Pre- and Post-Operative Considerations in Lower Limb Amputation
Types of Surgery
Syme's Amputation
Below Knee Amputation
Above Knee Amputation
Hip Disarticulation
Pain Management
Types of Lower Limb Prosthetic Hardware
Literature Review Section

From the Paper:

"Sometimes, especially after recorded history began, the reasons for needed prosthetic devices sounded eerily like some of the major 'hero' stories of today; the young man who cut off his own arm to escape entrapment in a crevice on a lonely mountain is one recent example. A few years ago, a man cut off his own lower leg when he caught it in a bear trap far from home or help. However, in Herodotus' The Histories, dating to 484 BCE, there is a story of a Persian named Hegestratus. Hegistratus was captured by the enemy and imprisoned with a leg iron. To escape, he cut off part of his own foot; later, he is said to have worn a wooden replacement, a prosthesis (University of Iowa Health Care Web site). Another account, however, notes that he used a 'wooden filler' to escape, traveling 30 miles before he was captured and "had his head amputated" (Northwestern University Prosthetics-Orthotics Web site). Not only was there no prosthetic head, Hegistratus did not live long enough to investigate what was available in foot prostheses at the time. While much of this knowledge is based on the verbal record, there was physical evidence of early prostheses. A tomb in Capua, Italy, offered an artificial leg made from copper and wood and dating to 200 BCE. Bombing in World War II destroyed it, however."

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