Amputation: hindlimb

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Sections available in full article Introduction, Uses, Alternative techniques, Time required, Decision taking, Requirements, Materials required, Preparation, Procedure, Aftercare, Immediate Aftercare, Long term Aftercare, Sequelae, Complications, Prognosis, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr Andrew Gardiner BVM&S Cert SAS MSc MRCVS
Ms Jill Sammarco BVSc MRCVS DipACVS DipECVS

Introduction

  • Removal of the hindlimb by amputation at the mid-femoral level.
    Print off the owner factsheet Caring for the amputee dog Caring for the amputee dog to give to your client.

Uses

  • Neoplasia OsteosarcomaBone: neoplasia.
  • Irreparable fractures.
  • Incapacitating neurological dysfunction.
  • Intractable osteomyelitis Osteomyelitis.
  • Congenital or acquired deformity.
  • Severe soft tissue injuries eg, degloving or ischemia.

Advantages

  • The procedure is usually a 'salvage' option when no possibility of retention of a functional limb exists due to failure of other treatments or due to the expected course of a neoplastic condition.

Disadvantages

  • Appearance and/or functional locomotion of the amputated patient may be unacceptable to some owners, even after counseling.
  • Certain patients, eg large breed dogs with orthopedic disease in other limb(s), are not good candidates for amputation.

Preparation

  • 20 min.

Requirements

Materials required

Minimum equipment

  • Standard surgical pack.
  • Oscillating bone saw, hacksaw blade, Gigli wire or osteotome/mallet.

Ideal equipment

  • Electrocoagulation apparatus.

Minimum consumables

  • Synthetic absorbable suture material, eg polyglactin (Vicryl); polydioxanone (PDS), size 2/0.

Other requirements

  • A surgical assistant can be helpful.

Sequelae

Complications

  • Secondary metastasis in neoplastic diseases.

Prognosis

  • Depends on the reasons for amputation. If the primary disease is treated successfully, most patients cope well with amputation of the hindlimb.

Reasons for treatment failure

  • Usually due to progression of neoplastic diseases.
  • Poor patient selection.

Sources

Publications

  • Kirpensteijn J, van den Bos R & Endenburg N (1999) Adaptation of dogs to the amputation of a limb and their owners' satisfaction with the procedure. Vet Rec 144 , 115-118 PubMed.
  • Straw R C et al(1996) Limb-sparing surgery versus amputation for dogs with bone tumors. Vet Clin North Am Small Anim Pract 26 (1), 135-143 (Review) PubMed.

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