Above Knee Amputation
Genaral remarks
- Mostly (75%) performed for ongoing infection, pain and/or necrosis in the lower leg caused by inadequate distal circulation (in the absence of other reconstructive possibilities (e.g. bypass surgery))
- Other indications include severe trauma and tumors
- Wound healing may take several weeks, but the emotional adaption can take months
- Above-knee amputees form the second largest group of all amputees
Step by step
- Sterile exposure
- Draw a fish mouth shape incision line
- Skin incision
- Subcutaneous dissection
- Opening fascia
- Identify and ligate the the large saphenous vein on the medial site of the femur
- Dissection of the muscle fibers and therby creating the ventral and dorsal flap
- Identify and ligate the large vessels on the posterior side of the femur (femoral artery)
- Identify and cut the femoral nerve that also lies posterior to the femur
- Shorten the nerve and burry it deep into the muscle to prevent painful post-operative neuroma
- Divide the femur
- Rasp the femur end
- Dissection of the remaining muscle fibers
- Closing the fascia with single sutures
- Skin closure with single (donati) sutures
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