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| | Lower Extremity Limb Salvage: Decision Making & Technical Challenges |
 | | The success of limb salvage surgery is squarely on the shoulders of the physician and our ability to convey the realities of the salvage process to our patients such that unrealistic expectations do not cause early psychologic failures. | | | The patients that produce the decision-making dilemma are those with significant injuries or injury to the lower extremity yet has a viable foot (Figure 1A-1C), and the prognosis for a functional limb is so poor that primary amputation is indicated, but oftentimes not performed during their primary hospitalization. | | | Often the surgical exercises of limb salvage are needed to restore function to the limb without the limb ever being at risk from a physiologic standpoint. |
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http://www.dcmsonline.org/jax-medicine/1998journals/may1998/lowerextremity.htm
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| | Body Image: The Lower-Limb Amputee - Journal of Prosthetics and Orthotics, 1997 American Academy of Orthotists & ... |
| | Should an individual have a limb amputated, the person will tend to compare the appearance of his or her body and functional capabilities to others'. | | | Shontz (14) suggests an individual who is missing a limb has three body images: the preamputation intact body, the body with limb loss and the body image when wearing a prosthesis. | | | The findings of this study agree with Cash and Frank and further support the idea that the perception the amputee has of his or her body image is not influenced by chronology. |
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http://www.oandp.org/jpo/library/1997_02_058.asp
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| | CHIN et al.: Endurance training for lower limb amputees |
| | The aim of this research is to investigate whether or not endurance training based on each subject's AT gained from the one-leg cycling test is useful in improving the physical fitness of lower limb amputees. | | | However, in the past the prescriptions of exercise training for lower limb amputees have not been appropriately accomplished. | | | The aim of this research is to investigate whether or not endurance training based on each subject's anaerobic threshold (AT) obtained from the one-leg cycling test is useful in improving the physical fitness of lower limb amputees. |
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http://www.vard.org/jour/01/38/1/chin381.htm
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| | ePodiatry - Assessment of the Lower Limb |
| | The chapter on orthopaedic assessment covers an orthopaedic overview of the lower limb, which is insufficiently detailed in regard to assessment of joint movements and muscle tissue for students or practitioners of manual therapy. | | | It is a comprehensive text covering all aspects of lower limb assessment and includes some general but related issues such as clinical measurement. | | | The Second Edition of this highly respected and well-established guide to lower limb examination and assessment of the foot provides completely revised and comprehensive coverage of the subject. |
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http://www.epodiatry.com/Merriman.asp
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| | The time course and direction of lower limb vascular conductance changes during voluntary and electrically evoked ... |
| | This study aimed to clarify the direction and timing of the change of non-active lower limb vascular conductance at the onset of contralateral limb isometric exercise and to examine the mechanisms controlling this change. | | | In subsets of subjects the presence of inadvertent muscle contraction was monitored by calf muscle EMG and the effects of the sensation of electrical stimulation without muscle contraction (sham) were investigated. | | | The time course and direction of lower limb vascular conductance changes during voluntary and electrically evoked isometric exercise of the contralateral calf muscle in man -- Fisher and White 546 (1): 315 -- The Journal of Physiology Online |
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http://jp.physoc.org/cgi/content/abstract/546/1/315
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| | Lower-Limb Pediatric Prosthetics: General Considerations and Philosophy - Journal of Prosthetics and Orthotics, 1992 ... |
| | Again, the child's parents and family situation are primary determinants of his or her adjustment to limb absence. | | | Congenital transverse deficiencies presenting themselves as homologues of Syme's or partial foot amputations are also fitted with basic prosthetic techniques and componentry based upon thorough evaluation of the patient. | | | Finally, since the child is dependent on a family group, pressures he or she feels in these areas are very different from adults. |
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http://www.oandp.org/jpo/library/1992_04_196.asp
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| | Nerve Blocks for Anaesthesia and Analgesia of the Lower Limb (page 1) |
| | Note that this nerve is blocked with the posterior approaches and is often missed with the anterior approach to the sciatic nerve. | | | The purpose of this guide is to provide a detailed, step by step description of how to safely and reliably perform nerve blocks for surgery and pain relief on the lower limb, for the non-specialist anaesthetic practitioner. | | | Posterior cutaneous nerve of the thigh: supplies skin over the posterior (back) thigh, the popliteal fossa, the lower buttock and some of the genital area. |
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http://www.nda.ox.ac.uk/wfsa/html/u11/u1112_01.htm
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| | eMedicine - Lower Limb Prosthetics : Article by Valerie S Bodeau, MD |
| | The rehabilitation team typically consists of a physiatrist (a physician who specializes in physical medicine and rehabilitation), an occupational therapist, a physical therapist, a prosthetist, a recreational therapist, and a case manager/social worker. | | | Initially, teach the patient the basics of prosthetics care, including how to don and doff the prosthesis, how to inspect the residual limb for signs of skin breakdown (should be completed daily), and how to perform safe transfers (moving from one position or surface to another). | | | Scar management is focused on massaging and lubricating the scar to obtain a well-healed result without dog ears or adhesions. |
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http://www.emedicine.com/pmr/topic175.htm
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| | abdomen and lower limb |
| | The lower portions of both the internal oblique and transversus abdominis muscles arise from the anterior superior iliac spine and attach to the pubic tubercle, as does the inguinal ligament. | | | For the limbs, ventral rami of spinal nerves from several cord levels unite to form plexuses (brachial and lumbosacral) in which fibers are exchanged. | | | However, the fibers of the transversus and internal oblique muscles fuse lateral to the deep inguinal ring and form an arch which becomes aponeurotic as it descends to attach to the pubic tubercle. |
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http://www2.hawaii.edu/~rosenhei/abdomen.html
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| | Consultants Special Interests - Region: NW. Keyword: limb |
| | Orthopaedics, Lower limb surgery arthroplasty, foot surgery, paediatric orthopaedics | | | Orthopaedics, Lower limb surgery, minimally invasive surgery, osteoarthritis in the young patient, foot problems | | | Orthopaedics, Lower limb surgery, hip surgery, knee surgery, trauma surgery |
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http://www.specialistinfo.com/siget.php?path=rrsi/NWlimb
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| | eMedicine - Lower Limb Orthotics : Article by Yingqi Xing, MD, MS |
| | The standing frame is used for children to learn standing balance and achieve a swing-through gait. | | | Considerations for orthotic prescription should include the 3-point pressure control system, static or dynamic stabilization, flexible material, and tissue tolerance to compression and shear force. | | | Jacobs SR: Rehabilitation of the person with arthritis of the ankle and foot. |
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http://www.emedicine.com/pmr/topic172.htm
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| | BASEM Managing the Lower Limb in Sport |
| | The emphasis will be on the functional assessment of the athlete in health and a detailed regional overview of acute and chronic problems in exercise. | | | Where possible the course will be delivered in small tutorial groups to facilitate the practical nature of this course. | | | The thoraco-lumbar spine, pelvis and lower limb course will include specific discussion of: |
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http://www.basem.co.uk/article.php?id=266&catid=43
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| | Lower Limb Prostheses |
| | A determination of the type of foot for the prosthetic will be made by the prescribing physician and/or the prosthetist based upon the functional needs of the patient. | | | Current condition, including the status of the residual limb and the nature of other medical problems; and | | | A lower limb prosthesis may be considered medically necessary when: |
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http://www.regence.com/trgmedpol/dme/dme18.html
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| | Unit 8:Lower Limb |
| | Identify the muscles associated with various aspects of walking, running and other functions of the lower limb | | | Upon completion of this laboratory exercise you should be able to: | | | Understand which bones contribute to each of the arches of the foot |
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http://courses.smsu.edu/emh420f/unit_8lower_limb.htm
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| | Critical lower limb ischemia |
| | Objective: To communicate the experience obtained during 5 years in the City of Uruapan Michoacan, Mexico in patients with critical lower limb ischemia (CLLI). | | | In our means these procedures continue being seen by the medical union with skepticism. | | | Conclusions: The bypass with safena vein in the patients with CLLI, is the best option to modify the natural history of this problem. |
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http://www.imbiomed.com.mx/Angio/Anv28n1/english/Zan001-01.html
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| | Unilateral Lower Limb Oedema in Pregnancy |
| | Passive movements of the limb were not painful and there was no calf tenderness. | | | Generalised oedema is attributed to cardiac, hepatic or renal pathology, malnutrition, protein-losing enteropathy, anaemia, hypoproteinaemia and hypothyroidism. | | | The patient is treated with bed rest and limb elevation till the oedema and limb tenderness subsides. |
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http://www.bhj.org/journal/2002_4401_jan/case_113.htm
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| | Dissector Answers - Superficial Lower Limb |
| | Images from "Anatomy of the Human Body" by Henry Gray are provided by: | | | Where does the sural nerve distribute and by what name? | | | However, the valves may become incompetent, resulting in retrograde blood flow from deep to superficial. |
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http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/limbs/femoral_ans.html
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| | Lower Limb Nerves |
| | The superficial peroneal nerve supplies the muscles in the lateral compartment (peroneus longus and brevis) and the skin over the anterior lower leg and dorsum of the foot. | | | The common peroneal nerve may be injured as it winds around the neck of the fibula, resulting in foot drop (anterior compartment muscles), and loss of sensation on the lower anterior leg and dorsum of the foot. | | | Cutaneous sensation would be lost over the calf and dorsum, sole and lateral side of the foot. |
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http://www.med.mun.ca/anatomyts/nerve/scianerv.htm
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| | LOWER LIMB ABNORMALITIES : Contact a Family - for families with disabled children: information on rare syndromes and ... |
| | A difference in limb length can occur before or after birth and cover a wide spectrum of conditions which affect the bones in the leg, most commonly involving shortened and/or absent bones. | | | Common lower limb disorders, such as femoral torsion (abnormal twisting of the femur), tibial torsion (twisting of the bone between the knee and the ankle) which can cause intoeing (feet turning inwards), and foot disorders such as metatarsus adductus (curving of the foot) and flat feet, rarely need complex treatment. | | | LOWER LIMB ABNORMALITIES : Contact a Family - for families with disabled children: information on rare syndromes and disorders |
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http://www.cafamily.org.uk/Direct/l42.html
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| | British Medical Journal: Ulcerated lower limb |
| | Leg ulcers are debilitating and painful and greatly reduce patients' quality of life. | | | However, because venous disease affects up to 30% of the population, it is not uncommon for patients with, for example, rheumatoid arthritis to have lower limb ulceration caused by venous disease. | | | Indeed, in up to half of patients with rheumatoid arthritis and leg ulcers the ulceration is due to venous disease rather than to the rheumatoid arthritis. |
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http://www.findarticles.com/p/articles/mi_m0999/is_7249_320/ai_63089401
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| | eMJA: Campbell et al, The lower limb in people with diabetes |
| | Disorganisation of joints and fragmentation of bones in the foot can follow, leading to a chronic deformity, referred to descriptively as the "Charcot rocker bottom foot", with subsequent pressure-induced plantar ulceration (Box 1). | | | The assessment of the lower limb includes the detection of peripheral neuropathy, vascular disease, deformities which may predispose to ulceration, any active lesions (ulceration or infection in particular) and the observation of gait and footwear (Box 2). | | | Lower limb ulcers in diabetes: a practical approach to diagnosis and management. |
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http://www.mja.com.au/public/issues/173_07_021000/campbell/campbell.html
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| | ABC News: Drug patch may relieve tendinitis symptoms |
| | The problem most often affected the shoulder or elbow, but all upper and lower limb locations were represented. | | | Dr. Bernard Mazieres from Rangueil University Hospital in Toulouse, France, and colleagues investigated the effectiveness and side effects of the ketoprofen patch in the treatment of 172 patients with tendinitis. | | | Pain in daily activities decreased by 55.6 percent in the ketoprofen patch group, compared with 36.8 percent in the placebo group, the authors report. |
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http://abcnews.go.com/Health/wireStory?id=1042987
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| | The lower limb |
| | Cutaneous nerves arise from the ventral rami of L1, 2, 3, 4. | | | The medial and lateral articulations are divided into upper and lower parts by the medial and lateral menisci (Clemente plate 387 fig. | | | runs anterior to the medial malleolus, crosses the lower 1/3 of the medial surface of tibia, |
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http://web.indstate.edu/thcme/duong/lower.html
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| | Lower Limb Bones |
| | The movements which occur at the hip joint are similar to those that take place at the shoulder joint except their range is more limited. | | | These small bones develop within the tendon of the flexor hallucis longus muscle to the big toe. | | | The toes have limited movement when compared to the movements of the fingers, especially the thumb. |
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http://mywebpages.comcast.net/wnor/llbones.htm
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| | On Yer Bike |
| | Although it maybe difficult and your sound side does all the work, in fact excercising the prosthetic side in beneficial to the development of muscle in the residual limb. | | | Toe in and out is less of consideration using this method as you can place the foot at any point along the pedal. | | | If the seat is too low both limbs will feel like they are not extending enough and may even hit you in the chest as you reach full extension. |
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http://amputee-online.com/amputee/onyerbike.html
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| | Diabetes in lower limb amputees. |
| | Table 1 summarizes the results of the study. | | | This may prevent or postpone diabetic complications, including amputation, since a clinician is likely to adopt a more aggressive approach to vascular risk factors if a patient is known to be diabetic. | | | SPARG was formed in 1991 and has an established network of senior physiotherapists with clinical responsibility for lower limb amputees in all 15 health regions in Scotland. |
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http://ourworld.compuserve.com/homepages/L_Lindsey/4320007.htm
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| | News - Complete Venous Ultrasound May Be Superior To Limited Ultrasound In Excluding Pulmonary Embolism |
| | The Regional Delegation for Clinical Research and Pharmacia Upjohn provided financial support for the study. | | | A DGReview of :"Diagnostic performance of complete lower limb venous ultrasound in patients with clinically suspected acute pulmonary embolism" | | | "Diagnostic performance of complete lower limb venous ultrasound in patients with clinically suspected acute pulmonary embolism" |
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http://www.docguide.com/news/content.nsf/news/8525697700573E1885256E070034FDF1
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| | eMJA: Payne, Diabetes-related lower-limb amputations in Australia |
| | This morbidity results in high medical and rehabilitation costs: about 10% of diabetes-related healthcare costs are associated with lower-limb amputations. | | | With proper foot care, patient education and provision of appropriate services, such as regular podiatric care, a reduction in the number of amputations can be achieved. | | | Lower extremity amputations in NIDDM: 12 year follow up study in Pima Indians. |
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http://www.mja.com.au/public/issues/173_07_021000/payne/payne.html
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| | LEGRO et al. Activities of lower-limb amputees |
| | Respondents were found to score significantly lower on each of the SF-36 subscales with the exception of mental health (p<0.01: social function; p<0.001: physical function, physical role, bodily pain, general health, vitality, and emotional role). | | | Issues of importance reported by persons with lower extremity amputations and prostheses. | | | Phantom limb, residual limb, and back pain after lower extremity amputations. |
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http://www.vard.org/jour/01/38/3/legro383.htm
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| | Can lower limb amputations... |
| | Their purpose was not only to document the incidence of amputations in diabetic patients in one German region but also to analyse a series of changes in therapeutic measures and their influence on the amputation rate. | | | One explanation for severe lesions is the very low rate of early detection of patients at high risk of diabetic foot disease. | | | Another explanation for the unchanged amputation rate could be the underestimation of foot problems by family physicians, since only one-quarter had participated in locally run quality courses on diabetes. |
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http://www.medforum.nl/idm/can_lower_limb_amputations___.htm
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| | Lower Limb Inequality |
| | In most cases, it may not be necessary to make adjustments for minor LLI (< 1 cm or 3/8 in) as with some adjustment to saddle height, the ankle rotation should take care of the situation unless it is causing lower back problems. | | | In some rare instances, you may identify a situation where both upper and lower LLI are present. | | | In many cases the first indication of LLI will be lower back pain caused by a constant (transverse) tilt of the pelvis. |
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http://www.billbostoncycles.com/lower_limb_inequality.htm
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| | Ottawa knee rule OK [March 1998; 49-2] |
| | Isolated tenderness of the patella (that is, no bone tenderness of the knee other than the patella). | | | No patient who did not have an X-ray was found subsequently to have a fracture. | | | Time spent in the emergency department, time spent off work, and overall medical costs were lower (by US$103 per patient) in those who did not have an X-ray than those who did. |
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http://www.jr2.ox.ac.uk/bandolier/band49/b49-2.html
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| | Smart Integrated Lower Limb |
| | Design of the individual component of the SILL system, as well as the control system that will integrate them, is underway. | | | The goal of the SILL project is to design a limb system that functions more like a sound limb; one that is both more functional and more comfortable. | | | The SILL design integrates the functions of the separate components, which will enable the wearer to better simulate human gait, even on varying terrain. |
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http://www.sandia.gov/isrc/SILL.html
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