TransPelvic/Hip Disarticulation_Clinical Decision Making [Ch. 11} Flashcards
Many transpelvic/hip disarticulation aputations are performed due to:
- Malignant LE bone tumors
Most common causes of amputation at hip disarticulation level (descending order): [5]
- Tumor
- Infection
- Vascular Disease
- Trauma
- Congenital abnormalities
- [2:1 male to female ratio}
Common complication of hip disarticulation surgery:
- Infection
Patients with hip disarticulation/transpelvic amputation need to maximize:
- upper extremity strength
- abdominal strength
- LE strength
Patients with a hip disarticulation need to initiate a _________ ______ ____ to initiate swing phase.
- Posterior pelvic tilt
With a hip disarticulation, balance training is important to enable the patient to:
- transfer independently
- apply and remove the prosthesis
- ambulate safely
The transpelvic socket:
- encases the abdominal cavity
- provides hard wall to enclose and compress the abdominal viscera so that they can accept weight bearing pressures
- Extends superior to the 10th rib to allow vertical loading
Weight transfer in the transpelvic socket is to the:
- Ischial tuberosity and buttock of the remaining leg
The hip disarticulation socket:
- Encloses the ischial tuberosity and gluteal muscles for weight bearing
- Extends over the ilium to provide suspension
- Encloses the opposite pelvis
- to assist in mediolateral trunk stability
- Contains reliefs over anterior and posterior iliac spine
Little to no bandaging is needed with a transpelvic or hip disarticulation amputation. [True/False]
- True
- Very little edema associated with these amputations
Primary hip disarticulation sockets in use [3]:
- Canadian
- Diagonal
- suitable for short transfemoral amputations at the level of the greater trochanter
- Total Contact Suction Socket
- most common
- allows better stabilization of the prosthesis
Endoskeletal prostheses are preferred due to:
- Lighter weight
- interchangeable and adjustable features
- improved cosmesis
Where is the hip joint attached in the Canadian and Total Contact Suction Socket, and why is it attached there?
- The hip joint is attached to socket anteriorly
- this causes the weight line to fall behind the hip and in front of the knee to assist with extension
A spring loaded hip joint that shortens the effective length of the limb which allows the wearer to swing the limb forward without having to vault.
- Hip flexion bias system
A component which is an elastic strap that passes behind the hip and in front of the knee which functions to limit hip flexion and assist with knee extension:
- Stride Length Control Strap
Type of knees commonly used in transpelvic/hip disarticulation:
-
Stance control knee
- resists knee flexion in excess of 15 degrees
- Disadvantage: must be non-weight bearing for more than 15 degree knee flexion to occur
- This makes it difficult to weight shift for sitting
-
Polycentric axis (four bar) knee
- center of rotation that changes or adapts to the degree of knee flexion
- Advantage:
- shortens during swing phase to aid in toe clearance
- If this component has pneumatic control it also helps control excessive heel rise and terminal swing impact
A component which enables the prosthetic leg to be crossed over the sound leg:
- Rotator adapter
- assists with getting in and out of an automobile
Lateral trunk bending toward the prosthetic side may be normal [true/false].
- True
- transpelvic/hip disarticulations are often made 1.25 cm shorter for easier foot clearance.
The individual with the hip disarticulation weight bears:
- On the ischium of the amputated side
The individual with the transpelvic amputation weight bears:
- On the ischium and buttock of the sound side
Prosthesis length may be determined by:
- For a hip disarticulation:
- Checking the bilateral iliac crest heights
- For a transpelvic amputation
- Checking the lower rib height
