Prosthetics Flashcards
Top 2 causes of LE
PVD
Trauma
Most common amputation site
TT > TF > TR
K levels
K0 - nonambulatory K1 - limited/household K2 - limited community K3 - community/variable cadence K4 - children/bilateral/active adults/athletes
How often should prosthetic socks/liners be replaced?
6 months
SACH foot
kids/durable
several activity levels/weights
can cause knee buckling
Single axis foot
accommodates uneven terrain indicated w/ knee instability anterior bumper stiffens DF posterior bumper slows foot drop CONTRAINDICATED if knee is stable
Dynamic response/energy storing foot
long keel lever
high level patients
Flexible keel
stops knee buckling of SACH foot
may be multi-axial
Training leg
Rotators
additional component that allows leg crossing/donning shoes (TF & proximal)
Torsion adapters
good for compliant surfaces
What phase of gait cycle do suspension systems help with?
swing phase
Supracondylar suspension
gives M-L stability
Indicated for shorter limbs/ligament laxity
When is manual locking knee contraindicated?
when anything else works
indicated with bilateral amputees (one leg)
Polycentric knee
COR relocates throughout ROM
leg can shorten for swing
knee disartic/short TF
weight activated stance control knee
if knee flexed < 10-15 deg brake engages & buckles knee if knee flexes > 15 deg
C-leg
in stance hydraulic fluid resistance
in stance its single axis
When are anatomic fit suspension systems used?
congenital amputee
How many socks should be limit before socket replacement?
> 12 ply
Amputee mobility predictor (AMP)
outcome measure that predicts amputee’s ability to ambulate
0-42 points
in amputee, when will they need more sock ply, morning or afternoon?
afternoon
Do you cover patella in ace wrapping amputee?
do not cover if active/complains of pain when covered
cover if edema in area of patella & short limbs
Key muscles to test for TT and TF/KD
TT - quadriceps
TF/KD - hip extensors/abductors
Typical contracture with TF/KD
FABER position
LisFranc amputation
tarsal-metatarsal joint
Syme’s amputation
rearfoot with trimming malleoli to create flat surface for weightbearing
Specific weight bearing interface
use soft tissue areas to achieve weight bearing & creates reliefs over bony prominences (opposing forces hold limb on)
Which pts are good candidates for specific weightbearing prostheses?
bony limbs past users preparatory prosthesis medium to short residual limbs pt who require knee stability
Total surface bearing prosthesis
circumferential pressure provides bearing characteristics
- -equal pressure distribution around pressure area
- -flow from area of most pressure to least
NOT good for hygiene
Which pts are good candidates for total surface bearing prostheses?
all lengths/all tissue consistencies
pts w/ abnormalities, scar tissues, adherent tissue, chronic breakdown
those who want distal attachment suspension systems
Hydrostatic prostesis
fluid becomes the soft area drawn distally to provide padding
Who should get hydrostatic prostheses?
pts who want distal attachment suspension systems
short, fleshy or medium residual limbs
active patients
Quadrilateral socket design
Not stable coronally
I.T. sits on ledge
squeezes medial to lateral to prevent lateral shift during gait
Ischial ramus containment socket design
I.T. inside socket
Stability coronally
squeezes anterior to posterior to keep I.T. on shelf
less pelvic shift with gait
Which muscles are lost from knee disarticulation to transfemoral if cut proximal to adductor tubercle?
adductor magnus semimembranosus sartorius gracilis semitendinosus
