Presentations
- Short or absent limbs or digits
- Traumatic limb loss
Conditions
- Congenital upper and lower limb differences
- Non-traumatic amputations, such as:
- infection
- ischemia
- tumour
- Traumatic amputations
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Multiple amputations, such as those occurring from meningococcal disease
- Multiple comorbidities, such as traumatic brain injury (TBI)
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Acquired amputation
- Aetiology and pathologies leading to amputation
- Incidence and prevalence, and mortality and morbidity, of limb injuries and amputation
- Prevention of traumatic limb injury and amputation
Congenital limb difference
- Aetiology, nomenclature, and pathogenesis of congenital limb differences
- Antenatal diagnosis
- Genetic and syndromic associations with limb differences
- Incidence of congenital limb differences
Clinical assessment tools
- Functional classification (K level)
Investigations
- Postnatal investigations, including:
- genetic tests
- medical imaging
Procedures
- Stump revision
- Surgical treatment options for congenital limb differences
- Types of surgical amputation
Complications of amputation
- Skin infections and breakdown
- Stump pain, such as:
- bony overgrowth and neuroma
- phantom pain and phantom sensation
- psychological impact, such as body image issues
Congenital upper and lower limb differences
- Antenatal and early family counselling
- Appropriate prosthetic management for:
- comorbidities
- the stage of development
- the underlying condition
- Liaison with orthopaedic team for surgical considerations
Education, sport, and recreation
- Liaison with school regarding activities in school curriculum
- Recreational prostheses
- Unique prosthetic needs and mobility goals for athletes
Post-amputation care
- Dressings and wound management
- Liaison with school and community providers
- Pain management
- Pre-prosthetic rehabilitation, such as prevention of contracture, and strengthening
Pre-amputation management
- Developmental considerations
- Pre-amputation pain, and prevention of postoperative pain
- Psychosocial assessment and support
Prosthetic management
- Early fitting and training with interim prostheses
- Longitudinal care, and transition to adult service
- Monitoring of wound and residual limb
- Prescription of appropriate prosthesis and prosthetic components, considering child’s developmental stage and psychosocial considerations
- Problems commonly seen in prosthetic ambulation
- Prosthetic alignment and adjustment
- Replacement of prosthetic components with growth and development
Prosthetic training
- Application of prosthesis and suspension
- Care and maintenance of prostheses
- Muscle strength and conditioning exercise
- Newer techniques to improve prosthesis control, such as osseointegration
- Patient expectations of prosthetic use
- Special needs of the bilateral amputee
- Training in prosthesis operational use, such as myoelectric hands
