Above knee amputee

[janleb]

I have a question . Last year I took care of a few amputee pt. I am going into my second yr of nursing school. Well what I want to know is with AKA, what happens to the muscle insertion at the knee? Do they have any hip flexion, do muscle contractures happen. BKA is preferred if possible I would suppose. Any input would be great, I have thought about this from time to time.Janice

[P_RN, ADN, RN]

Yes they do have flexion at the hip. Many times too much! If they begin to develop hip flexion contracture many times the surgeon will order a certain number of hours lying prone to prevent them. If the AKA is a one stage...then the muscles are wrapped around the end and the skin is closed. The docs usually order a stump shrinker to make the end of the amputation bullet shaped instead of flat on the end. The shrinker helps prepare the stump for future prosthesis use.

A two stage surgery would be if it were left open....as in traumatic amputation I&D and then closed at a future time. These are usually pretty bloody!