Clinical Case Database / Category: Patient Management
Lower limb amputation
Publication details
Miss Kiki Mistry BSc, MB BS, MRCS, Mr Aditya Prinja MA (Cantab), MB BS, MRCS, Mr Shiva Dindyal BSc (Hons)(Lond), MB BS (Hons)(Lond), MRCS (Edin), MRCS (Eng)
Foundation Years Journal, volume 7, issue 10, p.28 (123Doc Education, London, November 2013)
Abstract
A 68 year old gentleman with type II diabetes mellitus and a 50 pack year smoking history is admitted to hospital with severe rest pain in his left leg. He had a left femoro-popliteal bypass 12 months ago that has failed to improve his symptoms. His case is discussed at the Vascular Multidisciplinary Team meeting and it is decided that there are no further revascularization options available. The patient is listed for an above-knee amputation.
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Authors
Miss Kiki Mistry BSc, MB BS, MRCS
Core Surgical Trainee
The Whittington Hospital,
London
Mr Aditya Prinja MA (Cantab), MB BS, MRCS
Core Surgical Trainee
Colchester General Hospital,
Essex
Mr Shiva Dindyal BSc (Hons)(Lond), MB BS (Hons)(Lond), MRCS (Edin), MRCS (Eng)
General Surgery Specialist Registrar/Vascular and Endovascular Research Fellow
Barts and The London NHS Trust,
Barts and The London School of Medicine and Dentistry,
Circulatory Sciences Clinical Academic Unit,
Vascular and Endovascular Surgical Services,
The Royal London Hospital,
Whitechapel,
London, E1 1BB
References
1. NHS Choices: Amputation. www.nhs.uk/conditions/amputation.
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3. Houghton AD, Taylor PR, Thurlow S et al. Success rates for rehabilitation of vascular amputees: implications for preoperative assessment and amputation level. Br J Surg 79: 753-5, 1992.
4. Ruckley CV, Stonebridge PA, Prescott RJ. Skewflap versus long posterior flap in below-knee amputations: multicentre trial. J Vasc Surg 13: 423-7, 1991.
5. Nikolajsen L, Jensen TS. Phantom Limb Pain. Br J Anaesth 87: 107-16, 2001.
6. Patterson JF. Carbamazepine in the treatment of phantom limb pain. South Med J 81: 1100-2, 1988.
7. Karanikolas M, Aretha D, Tsolakis I, et al. Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial. Anesthesiology 2011; 114:1144.
8. Bradbrook D. Acupuncture treatment of phantom limb pain and phantom limb sensation in amputees. Acupunct Med 22: 93-7, 2004.
9. Moura VL, Faurot KR, Gaylord SA, Mann JD, Sill M, Lynch C et al. Mind-body interventions for treatment of phantom limb pain in persons with amputation. Am J Phys Med Rehabil. 91: 701-14, 2012.
10. Mulvey MR, Bagnall AM, Johnson MI, Marchant PR. Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults. Cochrane Database Syst Rev. 12: CD007264, 2010.
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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