During a below-the-knee amputation, what is the primary focus of the surgical technique?
Preserving the ankle joint
Removing all muscles from the affected limb
Creating a cosmetic incision line
Resecting the tibia and fibula bones
The Correct Answer is A
During a below-the-knee amputation, the primary focus of the surgical technique is to preserve the ankle joint whenever possible. This allows for better functional outcomes and facilitates the use of a prosthetic device.
b. Removing all muscles from the affected limb: While some muscle tissue is removed during amputation, the goal is not to remove all muscles. Some muscles are retained to provide coverage over the bone stump and to facilitate prosthetic fitting.
c. Creating a cosmetic incision line: While cosmetic considerations may be taken into account, the primary focus of the surgical technique is not solely on creating a cosmetic incision line. The incision is made to ensure appropriate tissue healing and to prevent complications.
d. Resecting the tibia and fibula bones: In a below-the-knee amputation, the tibia and fibula bones are typically resected to the appropriate level to accommodate the prosthetic device, but the primary focus is on preserving the ankle joint when possible.
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Correct Answer is C
Explanation
Peripheral vascular disease, which involves decreased blood flow to the extremities, is a common indication for amputation. In severe cases, where blood flow cannot be restored, amputation may be necessary to prevent further complications.
a. Chronic low back pain: Chronic low back pain is not an indication for amputation. It is usually managed through conservative treatments such as physical therapy, medications, or injections.
b. Osteoarthritis of the knee: Osteoarthritis of the knee may cause pain and mobility issues, but it does not typically lead to amputation. Treatment for osteoarthritis includes pain management, physical therapy, and, in some cases, joint replacement surgery.
d. Minor soft tissue injury: Minor soft tissue injuries do not require amputation. They are usually treated with wound care, rest, and possibly antibiotics if there is an infection.
Correct Answer is B
Explanation
Assessing the surgical incision for signs of infection is essential in the immediate post-operative period after amputation to detect any early signs of complications such as infection. Prompt identification and intervention can prevent further complications and promote healing.
a. Administering opioid pain medications regularly: While pain management is important after amputation, administering opioid pain medications regularly may lead to potential side effects and dependency. Pain medications should be given as needed and in response to the patient's pain level.
c. Encouraging the patient to perform active range of motion exercises: Active range of motion exercises may not be appropriate immediately after amputation due to wound healing and surgical site considerations. The focus in the immediate post-operative period is on wound care and monitoring.
d. Providing emotional support and counseling: Emotional support and counseling are essential for a patient who underwent amputation, but in the immediate post-operative period, the priority is on physical assessment and wound care.
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