You will be asked to examine this patient’s leg
- Look
- Ask patient to remove pants to look at both lower limbs
- “Patient has a BKA/ looks like a Midfoot amputation”
- Report grossly the appearance, no scar no erythema
- Note the other limb - presence (or absence) of diabetic dermopathy to suggest underlying cause of DM
- Walk [if this is forefoot amputation]
- Look at gait
- See if require any walking aid/ prosthesis
- Sit “I will now examine your stump, other leg and your prosthesis later”
- Once sit, pick up his prosthesis/ foot wear and mention a few things about the terminal device - is it or not energy storage?
- Examine stump
- Mention scar, good healing
- Presence of ulcer, pressure points
- No features of Choke syndrome, venous congestion such as that of verucuous hyperplasia
- Tap the stump for neuroma tinel
- Check sensation - risk factor for ulceration
- Examine joint above for contractures
- Examine other limb for “Etiology and at risk signs” - DM, Charcot, PVD
- Mention diabetic dermopathy
- Look at web spaces
- Check pulses
