Name of the Procedure:

Amputation, thigh, through femur, any level; secondary closure or scar revision.

Summary

In this procedure, a portion of the thigh bone (femur) and surrounding tissue is surgically removed, often followed by a secondary closure or revision of the scar to improve healing and function.

Purpose

The procedure addresses severe trauma, infection, tumors, or other conditions that damage the thigh and femur. The goal is to remove diseased or non-viable tissue to prevent further complications and to prepare the patient for eventual prosthetic fitting or improved quality of life.

Indications

• Severe traumatic injury to the thigh and femur
• Infections that do not respond to antibiotic treatment
• Bone cancer or other tumors in the femur
• Chronic non-healing wounds or ulcers
• Poor circulation resulting in gangrene

Preparation

• Pre-surgical evaluation and medical clearance
• Diagnostic imaging like X-rays or MRI
• Blood tests and possibly a pre-operative physical exam
• Fasting for 8-12 hours before surgery
• Adjustments or discontinuation of certain medications, like blood thinners

Procedure Description

1. Under anesthesia, an incision is made in the thigh.
2. The femur is surgically sawed through at the predetermined level.
3. Soft tissues (muscles, blood vessels, nerves) are carefully managed and severed.
4. The wound is cleansed, and a secondary closure technique is applied or a scar is revised.
5. The remaining tissue is shaped to accommodate a future prosthesis.
6. The surgical site is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes 2-4 hours.

Setting

It is performed in a hospital operating room under sterile conditions.

Personnel

• Orthopedic or general surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Common risks: Infection, bleeding, blood clots
• Rare risks: Nerve damage, long-term pain (phantom limb pain), complications from anesthesia, poor wound healing
• Complications: Non-healing wound, need for further surgery

Benefits

• Removal of diseased or damaged tissue
• Prevention of further infection or complications
• Improved potential for prosthetic use
• Enhanced quality of life and functionality

Recovery

• Hospital stay of a few days to a week
• Pain management with prescribed medications
• Wound care and monitoring for signs of infection
• Physical therapy and potential prosthetic fitting
• Follow-up appointments for wound checks and overall health
• Full recovery can take several months

Alternatives

• Limb-sparing surgery (if possible)
• Intensive antibiotic therapy (for infections)
• Radiation therapy or chemotherapy (for tumors)
• Pros of alternatives: Potential avoidance of amputation
• Cons: May not be as effective in removing diseased tissue, more extended treatment periods

Patient Experience

During the procedure, patients are under general anesthesia and will not feel any pain. Post-procedure, there may be discomfort and pain managed through medications. Physical therapy is crucial to regain mobility and prepare for prosthetic use, and emotional support is also essential to adapt to life after amputation.