Postoperative LE Management

Question 1

What are three different post-op edema control systems?

Answer 1

1. ACE bandages
2. Elastic shrinker/stockinette
3. Removable and non-removable Rigid Dressing

Question 2

What is the definition of K0-K4 functional level

Answer 2

K0 = nonambulatory
K1 = limited household ambulator
K2 = unlimited household, limited community ambulator
K3 = unlimited community ambulator
K4 = high energy activities

Question 3

What kind of prosthesis is K0 allowed?

Answer 3

No prosthesis

Question 4

What can a transtibial patient do while sitting to avoid knee flexion contracture?

Answer 4

Keep knee extended by placing it on a board

Question 5

What can you do during postop management to prevent scar adhesions?

Answer 5

Deep friction massage perpendicular to the scar

Question 6

What must amputee NOT do to avoid hip abduction contractures

Answer 6

Do not place a pillow between the legs

Question 7

What kind of foot and knee prostheses is K2 allowed?

Answer 7

Feet: multi-axis foot
Knee: pneumatic or polycentric knee

Question 8

How often must elastic bandages be changed for edema control?

Answer 8

Every 4-6 hours

Question 9

How many hours per day should amputee wear a shrinkage device

Answer 9

24 hours per day, except for bathing

Question 10

What kind of foot and knee prostheses is K3/4 allowed?

Answer 10

Feet: Energy-storing foot
Knee: hydraulic knee

Question 11

What is the ideal shape for a transtibial residual limb vs transfemoral residual limb

Answer 11

Transtibial = cylindrical
Transfemoral = conical

Question 12

What is a potential complication of using elastic bandages for edema control?

Answer 12

Can act as a tourniquet and cause constriction with distal edema

Question 13

What is the best post-op edema control system that allows daily inspection of wounds and prevents contractures

Answer 13

Removable Rigid Dressing

Question 14

What kind of foot and knee prostheses is K1 allowed?

Answer 14

Feet: SACH foot, single-axis foot
Knee: manual lock knee, stance-control knee

Question 15

What 3 things must a transtibial amputee NOT do to avoid knee flexion contractures?

Answer 15

1. Do not lie down with pillow under the knee
2. Do not have leg hanging over edge of bed
3. Do not sit for a long period of time with leg hanging

Question 16

What can transfemoral amputees do to prevent hip flexion contractures

Answer 16

Lie prone 15 minutes TID

Question 17

What 3 things should a transfemoral amputee NOT do to avoid hip flexion contractures?

Answer 17

1. Do not lie on mattress that is too soft
2. Do not raise head of bed
3. Do not place pillow under back or under thigh