PURPOSE: This study was done to explore the experiences of young adult males with below-knee amputation at surgical wards and clinics in Teaching Hospital, Kurunegala, Sri Lanka. DESIGN: The study used the phenomenology design of qualitative research. METHODS: Face-to-face interviews were conducted for data collection using a theme list with a saturation point reached at 16 participants. The duration of an interview was 30-45 minutes and was recorded on audiotape and transcribed later. Phases of familiarization with the data, coding, searching for themes, reviewing themes, defining and naming themes, and writing up were conducted accordingly to thematic analysis. FINDINGS: The young adult male below-knee amputees showed changes in lifestyle with dependence on others, supporting aids, and experiencing discomfort. They showed mental distress with dissatisfaction with life and suffering of life. Additionally, they lacked power with identity changes and encounter economic problems in their lives. CONCLUSIONS AND RECOMMENDATIONS: It is essential to give special education to the staff caring for the below-knee amputees to minimize their unpleasant and challenging experiences. Health staff can motivate family members and friends for individuals' mental adjustment to their new life. Additionally, the social attitude of the community should be changed positively regarding amputated patients.
Male ; Sri Lanka ; Disarticulation ; Musculoskeletal System

Metastatic tumors to the hand are rare and often overlooked by clinicians. Here, we report a rare case of phalangeal metastasis of right 4th finger in a patient with hepatocellular carcinoma. Treatment was given with right 4th finger disarticulation. This report suggests that physicians must take consideration into the possibility of metastatic tumors in patients with bone lesions on hands and a history of malignancy.
Carcinoma, Hepatocellular ; Disarticulation ; Fingers ; Hand ; Humans ; Neoplasm Metastasis

Since the entity of postmastectomy lymphangiosarcoma was first reported by Stewart and Traves in 1948, postmastectomy lymphangiosarcoma has become a well recognized, uncommon malignant tumor which occurs in the upper extremity following mastectomy for mammary carcinoma. The postmastectomy lymphangiosarcoma occurred at an average age of 63.9 years and at an average of 10 years and 3 months following mastectomy. The lymphangiosarcoma raised from blood and lymphatic vessel. The histologic appearance has been observed edematous dermis and dilated lymphatics lining with malignant cells. Most authors recommend radical amputation for treatment, either shoulder disarticulation or forequarter amputation. Other modalities of treatment including radiotherapy were considered as ineffective. The present report provides a case of the regression of postmastectomy lymphangiosarcoma with chronic lymphedima by external irradiation. Radiation therapy was used as primary therapy. Total tumor dose of 6500 cgy in 9 weeks was delivered using 6 MV x-ray and 8 MeV electron.
Amputation ; Dermis ; Disarticulation ; Lymphangiosarcoma* ; Lymphatic Vessels ; Lymphedema ; Mastectomy ; Radiotherapy ; Shoulder ; Upper Extremity

Yokenella regensburgei, a member of the family Enterobacteriaceae, is rarely isolated in humans. Here, we report a 71-year-old man with diabetic foot infection from which Y. regensburgei was isolated. Following debridement and disarticulation of the foot, an exudate specimen was obtained, from which Gramnegative bacilli were recovered. The organism was identified as Y. regensburgei using the Vitek 2 system (bioMerieux, USA) and 16S rRNA and gyrB gene sequencing. To our knowledge, this is the first case of Y. regensburgei isolation in Korea.
Aged ; Debridement ; Diabetic Foot* ; Disarticulation* ; Enterobacteriaceae ; Exudates and Transudates* ; Foot ; Humans ; Korea* ; Sequence Analysis, DNA ; Wounds and Injuries*

Synovial sarcoma is a very rare malignant tumor which arising from the synovial lining connective tissue, tendon sheaths and bursae. However, there are a few case reports of this tumor arising from the bone. We have experienced 3 cases of the tumor from the bone, i. e. the head of the left fibula, the sacrum and the right ileum, and the distal end of the left femur. Microscopically they showed typical slit like spaces, lined by epitheloid cells or cuboidal cells and one could easily find out spindle, polygonal, or giant cells. The proximal third of the left fibula was excised, and the other case arising from the sacrum & right ilium was treated with radiation therapy. Another case refused hip disarticulation, The effectiveness of the treatment is uncertain.
Connective Tissue ; Disarticulation ; Femur ; Fibula ; Giant Cells ; Head ; Hip ; Ileum ; Ilium ; Sacrum ; Sarcoma, Synovial ; Tendons

Upper limb amputations usually leave a significant functional limitation in activities of daily living for the amputees despite the use of a conventional prosthesis. New developments in prosthetic design have greatly increased the rehabilitation potential for active individuals with the upper limb amputation. The application of external power to artificial hands and elbow, and elimination of the control cables, the most unpopular feature of body-powered arms, has had a great impact on upper-limb prosthetics in the last two decades. We applied a myoelectric hand to a traumatic amputee with wrist disarticulation. As a result, it was possible to provide a considerable improvement in function and cosmesis with this new device. Further research will undoubtly improve the appearance, function and durability of the present electrically powered myoelectrical hand, making them even more acceptable and useful to the upper limb amputees.
Activities of Daily Living ; Amputation ; Amputees ; Arm ; Disarticulation* ; Elbow ; Hand* ; Humans ; Prostheses and Implants ; Rehabilitation ; Upper Extremity ; Wrist*

There have been a many reports of observational analysis on hip disarticulation prosthetic ambulation, but not a scientific analysis by a computerized motion analyzer. We present to share with our professional colleague our invaluable experience gained from the study on the gait analysis of a left hip disarticulation prosthetic gait. Using a Vicon 370 three dimensional gait analysis system, the gait analysis was performed in a left hip disarticulation patient fitted with a left Canadian type hip disarticulation prosthesis. In linear parameters, the cadence showed 79 steps/min, the gait speed was 0.68 m/sec, and the double support phase was 25.27% of a total gait cycle. In kinematics, the maximal pelvic tilt angle showed 29.92o at pre-swing phase, and significantly increased as compared with normal person. Hip motion change remained flexed, and maximal knee flexion angle disclosed 22.07o at the terminal stage of initial swing phase. In kinetics, the hip extension moment on initial contact stage was 0.089 NM/kg, which was impaired being compared with normal person. In conclusion, the increased pelvic tilt which implies that initiation of a prosthetic gait for hip disarticulation comes from a forward swing of the pelvis on the affected side, and an overall decrease of gait parameters accounts for the degree of disability of hip disarticulation amputee.
Amputees ; Biomechanical Phenomena ; Disarticulation* ; Gait* ; Hip* ; Humans ; Kinetics ; Knee ; Pelvis ; Prostheses and Implants ; Walking*

PURPOSE: In cases of high voltage electrical burns, a wound occurs as current enters or leaves the body and is accompanied by deep tissue injury. If upper extremity amputation is inevitable, consideration should be given to the residual limb functions, secondary reconstruction, and wearing of an upper prosthesis. Our hospital has achieved satisfactory outcomes through the use of a pedicled latissimus dorsi (LD) flap in patients undergoing transhumeral amputation and shoulder disarticulation due to upper extremity damage from high voltage electrical burns. METHODS: The study was targeted to five patients who suffered high voltage electrical burns, underwent above-elbow amputation, and were reconstructed in the acute and secondary phases using a pedicled LD flap from January 2005 to December 2011. All patients underwent equilateral pedicled LD flap surgery, with primary closure at the donating site. RESULTS: The average age of patients was 49.6 years (38~64); they were all male. One patient underwent sublayer skin grafting after a pedicled muscular LD flap, and four patients had a pedicled myocutaneous LD flap: one patient among the four had a forearm flap after the pedicled myocutaneous LD flap. All flaps were well adhered, and post-surgical flap reduction and local flaps were performed for adequate sizing and aesthetic improvement. CONCLUSION: In cases of upper arm amputation due to wide upper extremity damage caused by electrical burns, the use of the pedicled LD flap and adequate amputation length made subsequent wearing of a prosthesis possible. The pedicled LD flap procedure allowed reconstruction of a relatively large area of soft tissue and the surgery to the donating site was unproblematic.
Amputation ; Amputation Stumps ; Arm ; Burns ; Disarticulation ; Extremities ; Forearm ; Humans ; Male ; Prostheses and Implants ; Shoulder ; Skin Transplantation ; Upper Extremity

PURPOSE: The basic vascular anatomy and versatility of the anterolateral thigh flap was reported firstly by Song in 1984 and then by Zhang who introduced the reverse flow pattern of this flap. In this case, the authors reviewed various articles and their experiences with the distally based anterolateral thigh flap and applied it for coverage of bone-exposed wound occurred at the distal of the disarticulated knee stump. We consequently reported the reliability and resourcefulness of this flap in the difficult and limited situation. METHODS: A 67-year-old-man who had suffered from arteriosclerotic obliterans inevitably underwent the disarticulation at knee joint due to clinical deterioration. He presented to our clinic with soft tissue necrosis and bone exposure at the stump. We debrided the wound and conducted the distally based anterolateral thigh island flap by transecting proximal portion of descending branch of the lateral circumflex femoral artery and the 14x10cm sized flap was transferred to cover the defect. The pedicle measured 14cm in length with pivot point 7cm above the patella. RESULTS: The postoperative course was mainly uneventful except early venous congestion for 4 days and subsequent partial skin loss. The wound was healed by secondary intension and no other sequelae had been observed during follow-up period of 12 months. CONCLUSION: Despite the presence of various reconstructive choices, the distally based anterolateral thigh island flap can be designed to repair soft tissue defects around the knee region, providing its reliable blood supply and long pedicle length, especially in the challenging cases.
Disarticulation ; Femoral Artery ; Follow-Up Studies ; Hyperemia ; Knee Joint ; Knee* ; Music ; Necrosis ; Patella ; Skin ; Thigh* ; Wounds and Injuries

A 10-year-old boy with arteriovenous malformation (AVM) of the right lower limb was scheduled for an amputation of the affected limb. Limb amputation was necessary because of the ineffectiveness of previous sclerotherapy and the rapid progression of AVM causing pain and heart failure. Right hip disarticulation was considered the best option to improve his quality of life. To prevent congestive heart failure and uncontrollable hemorrhage during surgery, the disarticulation was done under a partial cardiopulmonary bypass. The patient underwent surgery successfully without complications.
Amputation ; Arteriovenous Malformations* ; Cardiopulmonary Bypass ; Child ; Disarticulation ; Extremities ; Heart Failure ; Hemorrhage ; Hip ; Humans ; Lower Extremity* ; Male ; Quality of Life ; Sclerotherapy