Amputations, Prosthetics, Orthotics and Rehabilitation MCQs

Orthopedics · 38 free questions with answers & explanations.

1. A 55-year-old diabetic man with peripheral vascular disease (ABI 0.4) has a non-healing below-knee gangrene. Transcutaneous oxygen pressure (TcPO2) at the proposed amputation site is 42 mmHg. What does this TcPO2 value indicate regarding healing potential?
2. A 30-year-old man undergoes a transtibial (below-knee) amputation following a traumatic injury. Regarding the ideal stump for prosthetic fitting, which statement is CORRECT?
3. A 40-year-old bilateral above-knee amputee (transfemoral) receives a microprocessor-controlled prosthetic knee (C-Leg). What is the primary advantage of a microprocessor knee over a purely mechanical knee for this patient?
4. Phantom limb pain is a well-recognised complication after amputation. Which of the following mechanisms is currently considered the primary pathophysiological explanation for phantom limb pain?
5. A 65-year-old patient with peripheral vascular disease and a non-healing toe gangrene requires amputation. The most common level of amputation that preserves the best prosthetic function and energy expenditure compared to above-knee amputation is:
6. Phantom limb pain (PLP) following amputation is thought to arise primarily from:
7. In a below-knee prosthesis, the SACH (Solid Ankle Cushion Heel) foot is the most basic energy-storing prosthetic foot. Its key limitation compared to a dynamic energy-return (carbon fibre) foot is:
8. In below-knee (transtibial) amputation, the optimal tibial stump length for best prosthetic fitting and function — balancing lever arm length with tissue coverage — is:
9. A 65-year-old man undergoes transfemoral (above-knee) amputation for peripheral vascular disease. On rehabilitation, the prosthetic knee joint most suitable for a community ambulator with moderate activity demands (K3 level — variable cadence walking, terrain variation) is:
10. A patient develops a neuroma at the end of the tibial nerve stump after below-knee amputation, causing severe end-stump pain on prosthetic loading. The pain mechanism of a traumatic neuroma and the currently preferred surgical treatment to prevent recurrence are:
11. The ideal length of the residual limb (stump) for a trans-tibial (below-knee) amputation to achieve optimal prosthetic fit and function is:
12. A patient undergoes trans-femoral (above-knee) amputation for a diabetic vascular complication. In prosthetic prescription, microprocessor-controlled knee joints (C-Leg) are particularly advantageous in which patient profile?
13. Phantom limb pain following amputation is thought to be primarily mediated by:
14. A 55-year-old diabetic man undergoes below-knee (transtibial) amputation for ischemic gangrene. The ideal residual limb (stump) length for optimal prosthetic fitting is:
15. A 45-year-old farmer undergoes right trans-femoral (above-knee) amputation after a farm machinery injury. He has good upper body strength and cardiovascular reserve. Which prosthetic knee component is most appropriate for a highly active user classified as K3 (MFCL — Medicare Functional Classification Level)?
16. Phantom limb pain following amputation is a neuropathic pain phenomenon. The neurobiological mechanism most supported by current evidence involves:
17. A 60-year-old man with L4–L5 lumbar spinal stenosis presents with neurogenic claudication. Conservative management has failed after 6 months. On nerve conduction studies and EMG, the finding that would most strongly support surgical decompression is:
18. A transtibial (below-knee) amputee is being fitted for a prosthesis. Which residual limb length is considered ideal for prosthetic fitting and function?
19. A Syme's amputation (ankle disarticulation) is advantageous over a transtibial amputation primarily because:
20. The ideal length of the residual limb (stump) for a below-knee (transtibial) amputation to achieve optimal prosthetic fitting and functional outcome is:
21. A 35-year-old man undergoes an above-knee (transfemoral) amputation for a vascular injury. During stump construction, myodesis is preferred over myoplasty because:
22. Phantom limb pain after amputation is best understood as arising from:
23. A Syme's amputation is performed at the level of:
24. A 55-year-old diabetic undergoes below-knee amputation for dry gangrene. Which is the MOST appropriate level of below-knee amputation for optimal prosthetic fitting?
25. The Syme's amputation differs from a standard below-knee amputation in that it involves:
26. A 35-year-old male undergoes transfemoral (above-knee) amputation following trauma. Six weeks later, he complains of burning, shooting pain in the phantom foot. The mechanism of phantom limb pain is best explained by:
27. A patient with bilateral transtibial (below-knee) amputations requires functional prostheses. Which prosthetic foot design is most appropriate for recreational running and high activity levels?
28. Myodesis during amputation surgery refers to:
29. The ideal level for below-knee amputation that provides the best prosthetic fitting and functional outcome is determined by which tibial remnant length?
30. Phantom limb pain after amputation is neurobiologically mediated primarily by which mechanism?
31. A patient with a transfemoral (above-knee) amputation is prescribed a prosthesis. The prosthetic knee unit that provides the best functional outcome for a K3-level (community ambulator) unilateral above-knee amputee is:
32. A 55-year-old diabetic with peripheral arterial disease undergoes a below-knee amputation. The surgical technique that preserves the long posterior flap (Burgess technique) is preferred over equal flaps. The rationale for using the long posterior flap is:
33. A 25-year-old soldier loses his right lower limb through the knee joint (knee disarticulation) following a blast injury. Compared to a transfemoral (above-knee) amputation, which biomechanical advantage does knee disarticulation offer for prosthetic fitting?
34. A 70-year-old woman with a transfemoral amputation is being fitted for a prosthesis. The optimal length of the residual femur for best prosthetic function is:
35. A phantom limb pain patient with a transtibial amputation experiences severe burning phantom pain refractory to gabapentin and amitriptyline. The neurophysiological mechanism underlying phantom limb pain is primarily:
36. In transtibial (below-knee) amputation for vascular disease, which residual limb length provides the best prosthetic fit and energy efficiency?
37. A 25-year-old soldier undergoes trans-femoral (above-knee) amputation after blast injury. Three months post-surgery, he develops episodic severe burning pain in the phantom limb. The neurophysiological basis of phantom limb pain is best explained by:
38. A rigid plaster dressing applied immediately after transtibial amputation serves which primary functional purpose beyond wound protection?