Week 13 Transfemoral

Question 1

Quadrilateral Socket

Answer 1

• Not used much anymore
• Anterior wall higher in front for stability, lateral wall adducted, medial wall perpendicular for counter pressure

Question 2

Ischial Containment Socket

Answer 2

• weight bearing primarily on the ischium and ischial ramus
• Socket design contains the ischial tuberosity and ramus to create a bony block for medial/lateral stability- very intimate fit
• Compared to quadrilateral better accommodates fleshy limbs and high activity patients
• Femur held in adduction

Question 3

Suction Suspension Advatages/Indications

Answer 3

• long residual limb
• stable limb volume
• good skin
• Good UE strength
• Best suspension/decreases pistoning
• Better proprioception
• No straps/belts

Question 4

Suction Suspension Disadvantages/Contraindications

Answer 4

• Volume fluctuation
• short residuals
• severe scarring
  -UE weakness
• Difficult to don
• Hot/lose suspension due to perspiration
• Requires a good SLS

Question 5

Gel Liners Advantages/Indications

Answer 5

• Provides positive suspension
• reduces shear forces
• active individuals
• stable limb volume
• fleshy limbs
• doesn’t limit ROM

Question 6

Gel Liners Disadvantages/Contraindications

Answer 6

• Relatively difficult to don
• skin reaction to gel liner/skin sensitivity
• Rotational control
• Hygiene problems
• Severe UE impairment

Question 7

Hip Joint and Pelvic Band Advantages/Indications

Answer 7

• Maximum medial lateral control
• Weak abductors or short residual
• Ease of donning
• Good swing phase control

Question 8

Hip joint Pelvic Band Disadvantages/Contraindications

Answer 8

• Bulky
• Inherent Pistoning
• Increased weight
• Don’t use if medial lateral stability is good

Question 9

Monolithic Axis

Answer 9

• No articulation
• Very young patients
• No room for the knee
• Not ready for muscular control
• No knee is incorporated into the prothesis

Question 10

Single Axis (outside hinge) Pros/Cons

Answer 10

Pros:
- Inexpensive
- durable
- Easily repaired
- Good muscular control/long residual limb
- Good for most levels of transfemoral limbs

Cons:
- Little inherent stability
- No stance control
- No variation in swing with gait speed changes
- Not suitable for patients with high functional levels
- Not appropriate for patients with short residual limb lacking mechanical advantage of long femoral lever/muscular control

Question 11

Polycentric knee Advantages/Disadvantages

Answer 11

Advantages:
- Provides some stance phase and swing phase control, easier initiation of knee flexion
- Good for long residual limbs
- Moving knee axis which provides for higher toe clearance on swing

Disadvantages:
- Increased wt
- Requires good voluntary knee control
- increased maintenance