Amputations and Prosthetics Flashcards
Syme’s Amputation
Surgical removal of the foot at the ankle joint with removal of the malleoli
Transverse tarsal (Chopart’s) Amputation
Amputation through the talonavicular and calcaneocuboid joints, which preserves plantar flexors but sacrifices dorsiflexors which results in an equinus contracture.
Tarsometatarsal (Lisfranc) Amputation
Surgical removal of the metatarsals, which preserves DF and PF.
K-level 0
Not eligible for prosthesis - totally immobile
K-level 1
Transfers
Ambulation on level surfaces
Fixed cadence
Household ambulator
K-level 2
Can ambulate curbs, stairs, uneven surfaces in the community
K-level 3
Variable cadence ambulator
Unlimited community ambulator
Prosthetic use beyond simple locomotion
K-level 4
Exceeds basic ambulation skills
Exhibits high impact, stress, or energy levels
(child, athlete, active adult)
SACH Component (Solid-Ankle Cushion Heel)
Non-articulating with rigid keel (rubber heel wedge) to mimic ankle action by compressing under load in early stance phase
Gait Deviations: Lateral bending
Prosthetic cause:
- prosthesis too short
- improperly shaped lateral wall
- high medial wall
- prosthesis aligned in abduction
User cause:
- poor balance
- abduction contracture
- improper training
- short residual limb
- weak abductors
- pain
Gait Deviations: Abducted Gait
Prosthetic cause:
- prosthesis too long
- high medial wall
- poorly shaped lateral wall
- prosthesis positioned in abduction
- Inadequate suspension
- excessive knee friction
User cause:
- abduction contracture
- improper training
- adductor roll
- weak hip flexors and adductors
- pain over lateral residual limb
Gait Deviations: Circumducted Gait
Prosthetic cause:
- Prosthesis too long
- excess knee friction
- socket too small
- excessive plantar flexion
User cause:
- abduction contracture
- improper training
- weak hip flexors
- inadequate knee flexion
- painful anterior distal residual limb
Gait Deviations: Excessive knee flexion during stance
Prosthetic cause:
- socket set forward in relation to foot
- excessive dorsiflexion
- stiff heel
- prosthesis too long
User cause:
- knee flexion contracture
- hip flexion contracture
- pain anteriorly in residual limb
- inadequate quad strength
- poor balance
Gait Deviations: Vaulting
Prosthetic Cause:
- prosthesis too long
- inadequate socket suspension
- excessive alignment stability
- excessive plantar flexion
User Cause:
- residual limb discomfort
- improper training
- fear of stubbing toe
- short residual limb
- painful hip/residual limb
Gait Deviations: Rotation of forefoot at heel strike
Prosthetic cause:
- excessive toe-out built in
- loose fitting socket
- inadequate suspension
- rigid SACH heel cushion
User cause:
- poor muscle control
- improper training
- weak medial rotators
- short residual limb
Gait Deviations: Forward trunk flexion
Prosthetic cause:
- socket too big
- poor suspension
- knee instability
User cause:
- hip flexion contracture
- weak hip extensors
- pain with ischial weight bearing
- inability to initiate knee flexion
Gait Deviations: Medial or Lateral Whip
Prosthetic cause:
- excessive rotation of the knee
- tight socket fit
- valgus in the prosthetic knee
- improper alignment of toe break
User cause:
- improper training
- weak hip rotators
- knee instability
Amputee Mobility Predictor (AMPPRO)
measures ambulatory potential of lower-limb prosthesis users. Balance, gait, and transfers are evaluated as part of the assessment and correlated to a K-level.
*AMPnoPRO - adaptation for users without a prosthetic limb
L-Test
similar to the TUG test with 3 differences
- a 90* turn is performed after the initial three meters
- the total length ambulated is 20 meters, not six
- four turns are involved
Prosthesis Evaluation Questionnaire (PEQ)
9 analogue scales used to assess satisfaction, well-being, frustration, pain, and residual limb health
Orthotics Prosthetics User Survey (OPUS)
survey consisting of functional status, quality of life, and satisfaction.
Trinity Amputation and Prosthesis Experience Scales-revised (TAPES-R)
multidimensional instrument designed to examine the psychosocial process involved in adjusting to using an amputation and prosthesis.
4 sections
- activity restriction
- psychosocial adjustment
- satisfaction with prosthesis
- factors influencing health both related to and unrelated to the amputation
Endoskeletal shank
rigid pylon covered with a material designed to simulate the contour and color of the contralateral limb
Exoskeletal shank
rigid external frame covered with a thin later of tinted plastic to match the skin color distally
