Base Camp ScoreBuilders Amputations and Prosthetics Flashcards
Type of Amputation- Forequarter (scapulothoracic):
Surgical removal of the upper extremity including the shoulder girdle
Type of Amputation- Shoulder Disarticulation:
Surgical removal of the upper extremity through the shoulder
Type of Amputation- Transhumeral:
Surgical removal of the upper extremity proximal to the elbow joint
Type of Amputation- Elbow Disarticulation:
Surgical removal of the lower arm and hand through the elbow joint
Type of Amputation- Transradial:
Surgical removal of the upper extremity distal to the elbow joint
Type of Amputation- Wrist Disarticulation:
Surgical removal of the hand through the wrist joint
Type of Amputation- Partial Hand:
Surgical removal of a portion of the hand and/or digits at either the transcarpal, transmetacarpal or transphalangeal level.
Type of Amputation- Digital Amputation :
Surgical removal of a digit at either the metacarpophalangeal, proximal interphalangeal or distal interphalangeal level.
Type of Amputation- Hemicorporectomy:
Surgical removal of the pelvis and both lower extremities
Type of Amputation- Hemipelvectomy:
Surgical removal of one half of the pelvis and the lower extremity
Type of Amputation- Hip Disarticulation:
Surgical removal of the lower extremity from the pelvis
Type of Amputation- Transfemoral:
Surgical removal of the lower extremity above the knee joint
Type of Amputation- Knee disarticulation:
Surgical removal of the lower extremity through the knee joint
Type of Amputation- Transtibial:
Surgical removal of the lower extremity below the knee joint
Type of Amputation- Syme’s:
Surgical removal of the foot at the ankle joint with removal of the malleoli
Type of Amputation- Transverse Tarsal (Chopart’s):
Amputation through the talonavicular and calcaneocuboid joints. The amputation preserves the plantarflexors, but sacrifices the dorsiflexors often resulting in an equinus contracture.
Type of Amputation- Tarsometatarsal (Lisfranc):
Surgical removal of the metatarsals. The amputation preserves the dorsiflexors and plantarflexors.
Components of UE Prosthetics- Transradial Socket
- Standard socket covers two-thirds of forearm
- Standard socket may be shortened to allow for increased pronation/supination ability.
- Supracondylar sockets are self-suspending and require no additional harness apparatus
Components of UE Prosthetics- Transradial Suspension
- Triceps Cuff
- Harness
- Cable System
Components of UE Prosthetics- Transradial Elbow Unit
- Attaches to either triceps cuff or upper arm pad
- Flexible or rigid hinge connects socket to proximal component.
Components of UE Prosthetics- Transradial Wrist Unit
- Quick Change Unit
- Wrist Flexion Unit
- Ball and Socket
- Constant Friction
Components of UE Prosthetics- Transradial Terminal Device
- Voluntary opening or closing
- Body- Powered, Externally powered, myoelectric or hybrid
- Hook, mechanical hand, cosmetic glove
Components of UE Prosthetics- Transhumeral Socket
- Standard Socket extends to acromion level
- Modified design allows fro more stability with rotational movements
- Lightweight friction units may be used with passive prosthetic arms
Components of UE Prosthetics- Transhumeral Suspension
- Harness
- Cable System
- Suction
Components of UE Prosthetics- Transhumeral Elbow Unit
- Internal or external locking elbow unit
Components of UE Prosthetics- Transhumeral Wrist Unit (Same as transradial)
- Quick Change Unit
- Wrist Flexion Unit
- Ball and Socket
- Constant Friction
Components of UE Prosthetics- Transhumeral Terminal Device (same as transradial)
- Voluntary opening or closing
- Body- Powered, Externally powered, myoelectric or hybrid
- Hook, mechanical hand, cosmetic glove
Components of LE Prothetics- Transfemoral Socket
- Quadrilateral
- Ischial Containment
Components of LE Prothetics- Transfemoral Suspension
- Lanyard Strap
- Shuttle lock
- Suction (seal-in liner; skin fit)
- Partial Suction (silesian bandage, pelvic belt/band)
- Vacuum
Components of LE Prothetics- Transfemoral Knee
- Single axis
- Polycentric
- Hydraulic
- Microprocessor
Components of LE Prothetics- Transfemoral Shank
- Exoskeleton (rigid exterior)
- Endoskeleton (pylon covered with foam)
Components of LE Prothetics- Transfemoral Foot System
- Solid Ankle Cushion (SACH)
- Stationary Attachment Flexible Endoskeleton (SAFE)
- Single Axis
- Multi- axial
- Hydraulic
- Powered
- Dynamic Response
Components of LE Prothetics- Transtibial Socket
- Patellar Tendon Bearing (PTB)
- Supracondylar Patella Tendon Socket (PTS)
- Supracondylar- Suprapatellar Socket (SC- SP)
Components of LE Prothetics- Transtibial Suspension
- Supracondylar Cuff
- Thigh Corset
- Supracondylar Brim
- Rubber/ Neoprene Sleeve Suspension
- Waist belt with fork strap
- Suction with knee sleeve
- Shuttle lock
- Vacuum
Components of LE Prothetics- Transtibial Shank (same as transfemoral)
- Exoskeleton (rigid exterior)
- Endoskeleton (pylon covered with foam)
Components of LE Prothetics- Transtibial Foot System (Same as transfemoral)
- Solid Ankle Cushion (SACH)
- Stationary Attachment Flexible Endoskeleton (SAFE)
- Single Axis
- Multi- axial
- Hydraulic
- Powered
- Dynamic Response
Influence of Single Axis Knee:
- Difficult to reciprocate during gait
- May or may not have knee extension assist and/or a weight-activated stance phase control
- Constant friction mechanism
Influence of Polycentric Knee
- Heavier than a single axis
- Reciprocal gait is more fluid
- May or may not have a knee extension assist and/or weight- activated stance phase control
- Constant friction mechanism
Influence of Hydraulic Knee
- Variable friction for improved swing and stance phase control
Influence of Microprocessor Knee
- Multiple programs available to accommodate the activity level of the user
- Allows for fluid management of descending stairs
- Requires charging
- Variable friction for improved swing and stance phase control
Influence of SACH foot
- Non-articulating with a rigid keel
- Inexpensive
- Low maintenance
- Cushioned heel for shock absorption
- Lacks energy return
- Cannot accommodate to uneven surfaces
Influence of Single Axis
- Allows for motion in a singular plane
- Improved knee stability during weight acceptance
- Lacks energy return function if not paired with dynamic response foot
Influence of Dynamic Response
- Can be articulating or non-articulating
- Keel has the capability to store and return some energy
- May have a split keel to allow for improved surface accommodation
Influence of Hydraulic/ Microprocessor
- Finer control over the stability/ mobility of motions
- Improved shock absorption
- Not appropriate for all environmental conditions and demands
Advantages of Rigid (Plaster of Paris) Dressing
- Allows for early ambulation with pylon
- Promotes circulation and healing
- Stimulates proprioception
- Provides protection
- Provides soft tissue support
- Limits edema
- Ability to utilize an immediate post-operative prosthesis (IPOP)
Disadvantages of Rigid (Plaster of Paris) Dressing
- Immediate wound inspection is not possible
- Does not allow for daily dressing change
- Requires professional application
Advantages of Non- Weight Bearing Rigid Removable Limb Protectors
- Removable
- Accommodates edema fluctuation
- Easily applied
- Prevents Contracture
- Provides Protection
Disadvantages of Non- Weight Bearing Rigid Removable Limb Protectors
- Not for ambulatory purposes
Advantages of Semi-rigid (Unna paste, air splint)
- Reduces post-operative edema
- Provides soft tissue support
- Allows for earlier ambulation
- Provides protection
- Easily changeable
Disadvantages of of Semi-rigid (Unna paste, air splint)
- Does not protect as well as rigid dressing
- Requires more changing than rigid dressing
- May loosen and allow for development of edema
Advantages of Soft (ace wrap, shrinker)
- Reduces post-operative edema
- Provides some protection
- Relatively inexpensive
- Easily removed for wound inspection
- Allows for active joint ROM
Disadvantages of Soft (ace wrap, shrinker)
- Tissue healing is interrupted by frequent dressing changes
- Joint ROM may delay the healing of the incision
- Less control of residual limb pain
- cannot control the amount of tension in the bandage
- Risk of a tourniquet effect
- Shrinker cannot be applied until sutures/staples are removed
Medicare Functional Classification Level Scale- K0
Prosthesis will not enhance quality of life or mobility
Medicare Functional Classification Level Scale- K0 Knee Unit
Not eligible for prosthesis
Medicare Functional Classification Level Scale- K0 foot/ankle assembly
Not eligible for prosthesis
Medicare Functional Classification Level Scale- K1
- Transfers
- Ambulate on level surfaces
- Fixed Cadence
- Limited or unlimited household ambulator
Medicare Functional Classification Level Scale- K1 Knee Unit
- Single Axis
- Constant Friction
Medicare Functional Classification Level Scale- K1 Foot/ Ankle Assembly
- SACH
- Single Axis
Medicare Functional Classification Level Scale- K2
- Traverse low-level barriers: curbs, stairs, uneven surfaces
- Limited community ambulator
Medicare Functional Classification Level Scale- K2 Knee Unit
- Polycentric
- Constant Friction Mechanism
Medicare Functional Classification Level Scale- K2 Foot/ Ankle Assembly
- Flexible- keel foot
- Multi-axial foot/ankle
Medicare Functional Classification Level Scale- K3
- Variable cadence ambulator
- Unlimited Community ambulator
- Traverse most environmental barriers
- Prosthetic use beyond simple locomotion
Medicare Functional Classification Level Scale- K3 Knee Unit
- Hydraulic/Pneumatic
- Microprocessor
- Variable Friction Mechanism
Medicare Functional Classification Level Scale- K3 Foot/ Ankle Assembly
- Energy Storing
- Dynamic Response Foot
- Multi-axial foot/ankle
Medicare Functional Classification Level Scale- K4
- Exceeds basic ambulation skills
- Exhibits high impact, stress, or energy levels
- Typical of child, athlete, or active adult
Medicare Functional Classification Level Scale- K4 Knee Unit
- Any System
Medicare Functional Classification Level Scale- K4 Foot/ Ankle assembly
- Any System
Most common complaint of new prosthesis wearer?
Comfort of the socket on the residual limb
If the fit of the socket is too tight what should the therapist determine?
If the patient has been wearing their shrinker throughout the day when not wearing their prosthesis if so review medications and diet.
Phase immediately post amputation is referred to as?
Pre-prosthetic phase
In general, how long is the pre-prosthetic phase?
~6 weeks
What is the focus of therapy for the pre-prosthetic phase?
Contracture prevention, protecting the limb, developing single limb mobility skills, and preparing the patient for the prosthetic phase of rehabilitation.
In general, when is a patient evaluate for their first prosthesis?
~ 4-6 weeks post surgical
When can a patient start wearing a shrinker?
Once the sutures and/or staples are removed
How often does medicare support a new prosthesis?
Every 5 years
What size of wrap should be used for UE amputations?
2-4 inch wrap
What size of wrap should be used for transtibial amputations?
3-4 inch wrap
What size of wrap should be used for transfemoral amputations?
6 inch wrap
