LECTURE 13: PROSTHETICS 2 Flashcards
MOST common LE amputation
partial foot
*need shoe modifications
orthotics/prosthetics
biomechanical deficiencies in gait due to partial foot amputation
Reduced plantar weight bearing surface
Impaired pronation/supination
Loss of active push-off
great toe amputation orthotic
custom shoe insert for great toe amputation
tibial tubercle height (with AFO type) is for
increasing toe lever arm
spreads forces over larger area
what is a symes amputation
ankle disarticulation
custom molded trans tibial amputation
liner
cast over liner
mark the bony landmarks (fib head, patellar tendon)
plaster cast
below knee sockets: how do you divide the pressure
PTB: patella tendon bearing
50% patella tendon
20% tibial flare
30% tissue
total surface bearing for equally distributed pressure
BK sockets what are the pressure tolerant vs sensitive areas
pressure sensitive areas: anterior/distal tibia, fibula –> add plaster
pressure tolerant areas: patella tendon –> remove plaster
transfemoral sockets: pressure tolerant vs sensitive areas
pressure tolerant areas: 50% of weight on Ischial Tuberosities
*The rest through Soft Tissues
Pressure Sensitive Areas
* Pubic Ramus
* Symphasis Pubis
* Adductor Tendon
* Lateral Distal Femur
Are knee disarticulations recommended?
Now more common
hip disarticulation: what is tough about these?
entire femur missing
not much area to spread load around
pressure on glute max, isch tubs
*very hard to get hip knee and ankle joints to work together,
reasons: cancer, prognosis is not always very good
after creating mold, clear plaster socket is done through test fit. T or F
T
1-2 fittings bc this is most important part
suspension methods for transtibial/femoral
suspension sleeve (makes a seal/suction)
pin lock system (roll liner onto limb, pin goes into prosthesis)
Vacuum assisted suction socket (shock absorption, makes leg hold on really well)
what does a sock do?
helps make the socket fit (can adjust thickness)
electric pump
allows you to set how much vacuum you want
Feet and knees are controlled by k level.
If you are a K1…
solid ankle cushion heel
works for transfers (wood)
flexible keel foot is for what level
K2
*soft forefoot
dynamic response is for K levels
3 and 4
carbon fiber
flexeon
flexeon is indistructable.
Very very sturdy
multi axis foot
ankle that moves -> softer ride
single axis foot
LR: heel -> flat foot contact, promotes knee extension
What is special about the EMPOWER? (formerly BIOM)
active push off
(6-8 hour battery)
4 types of knees
weight activated safety
4 bar knee polycentric
hydraulic knee
microprocessor knee
what K level is weight activated “safety”
K2
