A PROSTHESIS IS DEFINED AS ARTIFICIAL REPLACEMENT OF A PART OR WHOLE OF A LOST LIMB
Removal of a part or whole of a limb is called amputation. Amputations are done when all other modalities are explored, evaluated and rejected and removal of the limb is considered as the best solution for the patient.
A few milestones in the history of amputation surgery are as follows:
First prosthesis was given to Hegistratus in 484 BC who was imprisoned, chained at ankle and was awaiting death penalty. At his attempt to escape, he cut his foot and after wound healing he started using a wooden leg.
Hippocrates in fourth century BC reported about ligatures which was reintroduced by Ambrose Pare, a French military surgeon in 1529. Pare also introduced the Elbow disarticulation. He is called as the founder of Modern
Principles of Amputation
First hip disarticulation was done by William Kerr of England in 1774.
Tarso metatarsal disarticulation was done by Lisfranc's, a French surgeon in 1815.
Disarticulation of ankle by James Symes in Edinburgh surgeon in 1843.
Antiseptic technique was introduced by Lord Lister in 1867.
Myoplasty was introduced by Burgess in 1956.
Immediate postoperative prosthesis was first fitted by Michael Berlemont in 1958.
Canadian hip disarticulation prosthesis was designed at Sunny Brook Hospital Toronto in 1954.
In 1955 Canadian Syme's prosthesis designed at the same hospital.
SACH foot was introduced by University of California in 1955.
In India first artificial limb center was started in Defense Medical College, Pune. Following that artificial limb center was started in Madras in the year 1965.4
The field was extensively developed by Prof. M Natarajan, Prof. IS Shanmugam, Prof. K Janardhanam and others and achieved the present status in Tamil Nadu.
STANDARD NOMENCLATURE
A standard nomenclature is needed for a global uniformity in understanding and management of amputations.
Old terminology | Current terminology |
---|---|
1. Below elbow | Transradial |
2. Above elbow | Transhumeral |
3. Below knee | Transtibial |
4. Above knee | Transfemoral |
5. Symes | Ankle disarticulation |
6. Hemi pelvectomy | Transpelvic |