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Orthotic, adaptive, protective, and assistive devices are implements and equipment used to support or protect weak or ineffective joints or muscles, and serve to enhance performance.1 The uses of appropriate orthotic, protective, and supportive devices are outlined in this chapter.

The major rationales for amputation include disease (diabetes, peripheral vascular disease [PVD]), infection (post joint replacement, osteomyelitis), tumor, trauma, and fractures that fail to heal (non-union).

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  • Amputation refers to the cutting of a limb along the long axis of the bone.
  • Disarticulation refers to cutting of a limb through the joint.

Major improvements in noninvasive diagnosis, revascularization, and wound healing techniques have lowered the overall incidence of amputations for vascular disease.2

Levels of Amputation3

Traumatic amputations may be performed at any level (Table 15–1). Whatever the level the surgeon attempts to maintain the maximum bone length and to keep as many joints intact as possible.2 The specific type of surgery depends on the status of the extremity at the time of amputation. Conservation of the residual limb and uncomplicated wound healing are both important.

Table 15–1. Levels of Amputation

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