MyMedR

Cameron JAP

Med J Malaya, 1950;5.

1. The importance of the mental and physical reactions of the amputee. 2. Ideal sites and the technique of amputations are discussed briefly. 3. Rehabilitation and training of the amputee is important if the best results are to be obtained. 4. Some of the special reasons for amputation are considered. 5. The component parts of an artificial limb and their alignment are outlined. 6. Special features in fitting limbs for women and children. 7. Some complications resulting from the wearing of an artificial limb are described. 8. Limb fitting in Malaya has its own peculiar difficulties which time and experience will rectify.

Matched MeSH terms: Amputation

Fulltext Amputation in hand surgery

Leung PC

Med J Malaysia, 1986 Sep;41(3):260-3.

PMID: 3312975

When referring to amputation, the immediate association tends to be amputation related to trauma. There is little doubt that injury is by far the commonest cause of amputation, but one must not forget that babies might also be born with amputations of the upper limb. This latter group of amelia composes the various types of congenital amputations.

Matched MeSH terms: Amputation/methods*; Amputation, Traumatic/surgery

Fulltext The ethics of penal amputation

Das AK

Indian J Med Ethics, 2020 5 13;V(2):143-148.

PMID: 32393455 DOI: 10.20529/IJME.2020.032

Malaysia is a South East Asian country with a racially diverse population. Islam is the state religion and about 60% of the population is Muslim, but the rights of other religious groups are protected by law. The Parti Islam se Malaysia, which has ruled the state of Kelantan since 1999, and believes that Malaysia should be ruled by Sharia law, recently proposed the implementation of Hudud laws in Kelantan. However, the federal government has ruled out its implementation. The suggestion stirred up a controversy among the physician community and the Malaysian Medical Association rejected a proposal by the state's political leadership to utilise the services of qualified surgeons to carry out punitive limb amputations. Several Islamic states such as Sudan, Saudi Arabia, and Iran practice Islamic penal justice, including amputations. The question therefore arises: how should a modern medical practitioner approach this ethical question? This study focuses mainly on Malaysia, but draws upon practices in other Islamic countries also.

Matched MeSH terms: Amputation*

Histomorphometric changes in the vessel wall at the site of amputation in diabetic patients--do they influence healing of the stump?

Naidu SV, Sengupta S

J Orthop Surg (Hong Kong), 2005 Apr;13(1):3-7.

PMID: 15872394

To predict healing of the stump by assessing the microscopic vascular changes at the amputation site.

Matched MeSH terms: Amputation*; Amputation Stumps/blood supply*; Amputation Stumps/physiopathology

Interface stress in socket/residual limb with transtibial prosthetic suspension systems during locomotion on slopes and stairs

Eshraghi A, Abu Osman NA, Gholizadeh H, Ali S, Abas WA

Am J Phys Med Rehabil, 2015 Jan;94(1):1-10.

PMID: 24919079 DOI: 10.1097/PHM.0000000000000134

This study aimed to compare the effects of different suspension methods on the interface stress inside the prosthetic sockets of transtibial amputees when negotiating ramps and stairs.

Matched MeSH terms: Amputation/rehabilitation*; Amputation Stumps/physiopathology*

Fulltext Interface pressure in transtibial socket during ascent and descent on stairs and its effect on patient satisfaction

Ali S, Abu Osman NA, Eshraghi A, Gholizadeh H, Abd Razak NA, Wan Abas WA

Clin Biomech (Bristol, Avon), 2013 Nov-Dec;28(9-10):994-9.

PMID: 24161521 DOI: 10.1016/j.clinbiomech.2013.09.004

Transtibial amputees encounter stairs and steps during their daily activities. The excessive pressure between residual limb/socket may reduce the walking capability of transtibial prosthetic users during ascent and descent on stairs. The purposes of the research were to evaluate the interface pressure between Dermo (shuttle lock) and Seal-In X5 (prosthetic valve) interface systems during stair ascent and descent, and to determine their satisfaction effects on users.

Matched MeSH terms: Amputation/rehabilitation*; Amputation Stumps/physiopathology*

Satisfaction and problems experienced with transfemoral suspension systems: a comparison between common suction socket and seal-in liner

Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S, Yahyavi ES

Arch Phys Med Rehabil, 2013 Aug;94(8):1584-9.

PMID: 23262380 DOI: 10.1016/j.apmr.2012.12.007

To compare a seal-in liner with the common suction socket with regards to patient satisfaction and problems experienced with the prosthesis.

Matched MeSH terms: Amputation/rehabilitation*; Amputation Stumps*

A case of sudden death eight days after amputation of the forearm

Gerrard PN

Lancet, 1901;158:908-909.

DOI: 10.1016/S0140-6736(01)73477-0

Matched MeSH terms: Amputation

Fulltext Response to Commentary by Adriaan van Es

Das AK

Indian J Med Ethics, 2020 5 13;V(2):151.

PMID: 32393445 DOI: 10.20529/IJME.2020.043

I would like to thank Dr Adriaan Van Es for his commentary (1) on my article (2). To start with, let me make one thing clear: I am not sure why he thinks that I am condoning the practice of penal amputation. As I clearly state in my conclusion, the arguments that may (or may not) justify penal amputation are abhorrent in liberal societies. We are on the same side here. But what of those who live in less secular societies where religious faith may be unquestioned? In my opinion, van Es has resorted to a typical example of a tortured form of ethical logic (3), which researchers from countries that have different value systems and different problems have deplored, albeit in a different context.

Matched MeSH terms: Amputation

Clinical evaluation of a prosthetic suspension system: Looped silicone liner

Abu Osman NA, Gholizadeh H, Eshraghi A, Wan Abas WAB

Prosthet Orthot Int, 2017 Oct;41(5):476-483.

PMID: 28946824 DOI: 10.1177/0309364616670396

OBJECTIVES: This study aimed to evaluate and compare a newly designed suspension system with a common suspension in the market.

STUDY DESIGN: Prospective study.

METHODS: Looped liners with hook fastener and Iceross Dermo Liner with pin/lock system were mechanically tested using a tensile testing machine in terms of system safety. A total of 10 transtibial amputees participated in this study and were asked to use these two different suspension systems. The pistoning was measured between the liner and socket through a photographic method. Three static axial loading conditions were implemented, namely, 30, 60, and 90 N. Furthermore, subjective feedback was obtained.

RESULTS: Tensile test results showed that both systems could safely tolerate the load applied to the prosthesis during ambulation. Clinical evaluation confirmed extremely low pistoning in both systems (i.e. less than 0.4 cm after adding 90 N traction load to the prosthesis). Subjective feedback also showed satisfaction with both systems. However, less traction at the end of the residual limb was reported while looped liner was used.

CONCLUSION: The looped liner with hook fastener is safe and a good alternative for individuals with transtibial amputation as this system could solve some problems with the current systems. Clinical relevance The looped liner and hook fastener were shown to be good alternative suspension for people with lower limb amputation especially those who have difficulty to use and align the pin/lock systems. This system could safely tolerate centrifugal forces applied to the prosthesis during normal and fast walking.

Matched MeSH terms: Amputation/methods*; Amputation Stumps/physiopathology

Fulltext Clinical Factors affecting Minor Amputation in Diabetic Foot Disease at Tengku Ampuan Afzan Hospital, Kuantan

Zakaria Z, Afifi M, Sharifudin MA

Malays J Med Sci, 2015 Mar-Apr;22(2):41-7.

PMID: 26023294 MyJurnal

Diabetic foot disease poses a substantial problem in Malaysian diabetic population. We evaluate the clinical factors affecting minor amputation in diabetic foot disease.

Matched MeSH terms: Amputation

A comparison of pressure distributions between two types of sockets in a bulbous stump

Gholizadeh H, Abu Osman NA, Eshraghi A, Arifin N, Chung TY

Prosthet Orthot Int, 2016 Aug;40(4):509-16.

PMID: 25583929 DOI: 10.1177/0309364614564022

BACKGROUND: This article describes a total surface bearing prosthetic socket for a patient (25-year-old female) with a bulbous stump.

CASE DESCRIPTION AND METHODS: The subject had unstable excessive soft tissue at the distal end of the residuum. After 2 years of prosthetic use, she experienced several problems, including pain in the residual limb and knee joint. Pressure distribution was evaluated during ambulation. We also designed a total surface bearing socket with Velcro as suspension system to distribute the load evenly on the residual limb, and to facilitate donning procedure.

FINDINGS AND OUTCOMES: The main site of weight bearing in the old prosthesis (patellar tendon bearing) was anterior proximal region of the residual limb, especially the patellar tendon. The pressure was almost 10 times higher than the distal region during level walking. Pressures were distributed more evenly with the total surface bearing socket design, and the donning was much easier.

CONCLUSION: Pressure distribution within the socket could be affected by socket design and suspension system. Using the total surface bearing socket and Velcro as suspension system might facilitate donning of prosthesis and reduce traction at the end of residual limb during the swing phase of gait.

CLINICAL RELEVANCE: Proper socket design and suspension system based on the amputees' need can facilitate rehabilitation process and lead to the amputee's satisfaction. The pressure is distributed more uniformly over the residual limb by the total surface bearing socket compared to the patellar tendon bearing socket for lower limb amputees with unusual stump shape.

Matched MeSH terms: Amputation; Amputation Stumps

Fulltext Balance control in lower extremity amputees during quiet standing: a systematic review

Ku PX, Abu Osman NA, Wan Abas WA

Gait Posture, 2014 Feb;39(2):672-82.

PMID: 24331296 DOI: 10.1016/j.gaitpost.2013.07.006

Postural control has been widely evaluated for the normal population and different groups over the past 20 years. Numerous studies have investigated postural control in quiet standing posture among amputees. However, a comprehensive analysis is lacking on the possible contributing factors to balance. The present systematic review highlights the current findings on variables that contribute to balance instability for lower extremity amputees. The search strategy was performed on PubMed, Web of Science, Medline, Scopus, and CINAHL and then followed by additional manual searching via reference lists in the reviewed articles. The quality of the articles was evaluated using a methodological quality assessment tool. This review included and evaluated a total of 23 full-text articles. Despite the inconsistencies in the methodological design of the studies, all articles scored above the acceptable level in terms of quality. A majority of the studies revealed that lower extremity amputees have increased postural sway in the standing posture. Asymmetry in body weight, which is mainly distributed in the non-amputated leg, was described. Aside from the centre of pressure in postural control, sensory inputs may be a related topic for investigation in view of evidence on their contribution, particularly visual input. Other balance-related factors, such as stump length and patients' confidence level, were also neglected. Further research requires examination on the potential factors that affect postural control as the information of standing postural is still limited.

Matched MeSH terms: Amputation Stumps/physiopathology*

Qualitative study of prosthetic suspension systems on transtibial amputees' satisfaction and perceived problems with their prosthetic devices

Ali S, Abu Osman NA, Naqshbandi MM, Eshraghi A, Kamyab M, Gholizadeh H

Arch Phys Med Rehabil, 2012 Nov;93(11):1919-23.

PMID: 22579945 DOI: 10.1016/j.apmr.2012.04.024

To investigate the effects of 3 dissimilar suspension systems on participants' satisfaction and perceived problems with their prostheses.

Matched MeSH terms: Amputation, Traumatic/rehabilitation*

Fulltext Two stage penile reconstruction with free prefabricated sensate radial forearm osteocutaneous flap

Ramesh S, Serjius A, Wong TB, Jagjeet S, John R

Med J Malaysia, 2008 Oct;63(4):343-5.

PMID: 19385502 MyJurnal

Penile reconstructive surgeries are performed mainly as radical treatment for conditions associated with congenital abnormalities of the urethra or penis, after penile trauma, penile cancer, short penis, corporal fibrosis and in cases of gender reassignment. We present here a method of penile reconstruction with a pre fabricated radial forearm free flap incorporating the segment of the radius for structural support.

Matched MeSH terms: Amputation, Traumatic/surgery*

Fulltext Low dose unilateral spinal anaesthesia for lower limb amputation in critically ill patients

Chuah KH, Thong CL, Krshnan H, Chan L

Med J Malaysia, 2007 Mar;62(1):81-2.

PMID: 17682582 MyJurnal

Patients with poorly controlled diabetes mellitus have an increased risk of lower limb infection and gangrene. In Malaysia, they frequently present late and are often in septic shock with multi-organ dysfunction. We report on two patients who presented for lower limb amputation in a desperate attempt to control sepsis and save their lives. Both patients were classified as ASA 5. Both patients had successfully undergone surgery under low dose unilateral spinal anaesthesia. The anaesthetic management of these critically ill patients in view of limited resources is discussed.

Matched MeSH terms: Amputation*

Fulltext Fillet flap: a successful procedure to preserve the optimum length of below-the knee-amputation stump in congenital constriction band of the leg

Sulaiman AR, Sallehudin AY, Shahidan Y, Iskandar MA, Halim AS

Med J Malaysia, 2005 Jul;60 Suppl C:119-21.

PMID: 16381298

The use of 'spare part' tissue from an amputated segment to cover a stump with soft tissue deficiency is a viable option for augmenting the shape of the stump and preserving functional length of the stump without additional donor morbidity. The procedure requires no microsurgical skill if the tissues are used as pedicle fillet flaps transfer. This concept of fillet flap makes the amputation distal to an unfavourable definitive amputation site such as in congenital constriction band possible. We report herein a case of amputation distal to constriction ring to illustrate the application of fillet flap in reconstruction surgery.

Matched MeSH terms: Amputation/methods*

Infanticide in Malaysia: two case reports and a review of literature

Ong BB, Green M

Am J Forensic Med Pathol, 2003 Mar;24(1):64-9.

PMID: 12605001

In a strict and conservative society like Malaysia, the number of cases of infanticide has continued to occur. The authors present two typical cases of infanticide in Malaysia. Case 1 concerned a body of a fully mature newborn fetus disposed in a rubbish bin. The head was traumatically amputated by the rubbish truck's compactor. The umbilical cord was still attached to the body, with no reddening around the insertion. The severed neck showed features consistent with post-mortem amputation. The significant finding was expanded crepitant lungs, which floated in water. The histology of the lungs showed expanded alveoli. It was concluded that the baby had been born alive, but no cause of death could be elicited. Case 2 concerned a decomposed mature newborn found in a scrub forest. The internal organs showed advanced putrefaction, the lungs being collapsed, congested, and hemorrhagic, typical of decomposed lungs. No conclusion could be made about the state of birth or the cause of death because of the putrefied state of the body. The two cases illustrate the typical cases and problems faced by pathologists locally and probably elsewhere in the world. Most of the bodies are found in a putrefied state. Pathologists have to ascertain not only maturity and live birth but also the cause of death, which may be very subtle or masked by putrefaction. The problems of diagnosis of live birth are discussed.

Matched MeSH terms: Amputation, Traumatic/pathology

Fulltext Major limb amputations in Seremban Hospital: a review of 204 cases from 1997-1999

Hazmy W, Mahamud M, Ashikin N, Jamilah S, Yee LE, Shong HK

Med J Malaysia, 2001 Jun;56 Suppl C:3-7.

PMID: 11814245 MyJurnal

We conducted a retrospective study of 3 years duration beginning from the 1st January 1997 to the 31st December 1999 in order to identify the epidemiology of major limb amputations in Seremban Hospital. Two hundred and four patients were included in this study out of which 65.7% were male and 34.3% were female. The mean age of the amputees was 39.7 years old. Non traumatic amputations constitute 85.8% of the cases mainly due to diabetic ulcers or gangrene (91%) followed by peripheral vascular disease (7%) and malignancy (2%). Traumatic amputations represent 14.2% of the cases with road-traffic accident as the major cause (82.8%) followed by industrial accident (17.2%). Lower limb amputations were performed in 97.5% of the cases with below knee amputations as the commonest procedure (72%), followed by above knee amputations (27%) and Syme amputations (1%). Five patients had upper limb amputations done. Four of them were below elbow amputations while one had forequarter amputation done of the left shoulder. Of note, there were increasing number of amputations done over the last three years with alarming increasing trends of traumatic amputation. The three main risk factors for major limb amputations are diabetes mellitus, male gender and road traffic accident.

Matched MeSH terms: Amputation/statistics & numerical data*

Fulltext A case report of acupuncture anaesthesia in amputation of the knee

Wong PTL

Med J Malaysia, 1980 Jun;34(4):347-8.

PMID: 7219261

A case report of right below-knee amputation successfully performed under acupuncture anaesthesia, supplemented with parenteral valium and. pethidine, is described.

Matched MeSH terms: Amputation*

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