What are some criteria for adult prosthetics?
condition of limb
ROM in proximal jt
desire to wear prosthesis <- most important
fairly good general health
well healed stump
free of metastatic CA
What type of prosthesis is used very early in the rehab procedure when youre making modifications?
What are some classifications of a preparatory/tempory prosthesis?
help in assessment of prosthetic candidancy/feasibility/indications for a permanent prosthesis
promote shape for permanent prosthesis
What type of prosthesis is cosmetically finished, comfortable, and has adequate function?
What are some characteristics of a foot-ankle assembly?
general contour of wearers foot
absorb shock at heel contact
simulates MTP hyperext in latter part of stance
may provide slight motion in the frontal and transverse plane
What are rotators?
component that is placed above the prosthetic foot to absorb shock in the transverse plane (inv/ever)
not in all prosthetics
protects wearer from chafing
most often used with single axis feet anf by very active wearers with transfemoral amputations
What restores the length and shape of a prosthetic and is adjacent to the foot-ankle assembly (or rotators)?
transmits the wearers body weight from the socket to the foot
What are the 2 types of shanks?
What type of shank is central aluminum, or rigid plastic pylon covered with foam?
rubber and a sturdy stocking
What are the advantages of an endoskeletal shank?
more life like
permits changes in angulation of the prosthesis which increases comfort and eas of gait
What type of shank is usually made of wood or plastic and presents a rigid exterior?
shaped to simulate the contour of the lg
What are the advantages of an exoskeletal shank?
impervious to liquids and most abrasives
What are the disadvantages to an exosketal shank?
does not provide for change in angulations of the prosthesis
What is the recepticle for which the amputated limb fits into?
designed to contact all portions of the residual limb for maximum load distribution
allows for venous blood circulation
provides tactile feedback
What do sockets have for sensitive/tolerant areas?
reliefs and build ups
What are the characteristics of an unlined socket?
good for wearer whos limbs have no stabilzed yet
wear uses socks or a sheath for a soft interface
a pad can be placed in the bottom to cushion the distal end of the limb
What are the characteristics of a lined socket?
usually resilient polyethylen foam liner
cushions the limb
facilitates alteration of socket size by adding material to the outside of the liner
*when a pt is up to 15ply of sock, the socket should be altered or replaced
What are the 4 most common transtibial suspension types?
supracondylar cuff suspension
neoprene/rubber with screw
What type of suspension is a cuff (leather strap) that encircles the thigh immediately above the femoral epicondyles?
user can easily adjust the snugness
What are the advantages of a supracondylar cuff?
allows normal knee motion
easy to don and doff
durable and easy to replace
good for house ambulation pts
What are the disadvantages of a supracondylar cuff?
does not eliminate pistoning (sliding up and down with amb)
no mediolateral knee stability (not good for bad knees)
may interfere with circulation of distal thigh in obese clients (bad for circulatory problems)
may cause pinching in distal thigh when sitting
What are the characteristics of a neoprene/rubber sleeve?
sleve covers the proximal socket and distal thigh
provides excellent suspension
streamlines the users silhouette in sitting
requires 2 strong hands to don
cannot be used with a thigh that has excessive subcutaneous tissue
What are the advantages of a neoprene/rubber sleeve?
better suspension than all other types except suction
no circumferential constriction
good for younger/more active pts
What are the disadvantages of a neoprene/rubber sleeve?
increased perspiration and heat
no mediolateral stability
not as durable as a cuff
more expensive than a cuff
What are the characteristics of a neoprene/rubber with a screw/pin (shuttle lock)?
silicone sheath with special hardware
provides secure suspension
sheath clings to pts skin during gait
What type of suspension has the medial and lateral walls extend above the femoral epicondyles?
increases medial/lateral stability
more difficult to fabricate (more expensive)
less readily adjustable
What are the advantages of a supracondylar/suprapatellar suspension?
no circumferential constrictions
aids in mediolateral stability
better suspension for short residual limbs
good for jacked up knees
What are the disadvatages of a supracondylar/suprapatellar suspension?
enclosed patella can limit kneeling
difficult to suspend over heavy thighs
What are the advantages of a waste belt?
provides auxillary suspension
some weight bearing on iliac crests
What are the disadvantages of a waist belt?
may be uncomfortable, esp for the obese
uneven suspension and swing
fork strap does not resist knee ext
more difficult to don
What are the advantages of suction?
minimizes shear forces on residual limb
does not limit knee flexion
good for younger/active pts
What are the disadvantages of suction?
may be difficult to don
increased perspiration and heat
most expensive of all suspensions
What are the 3 types of transfemoral suspensions?
What type of suction has the internal socket pressure less than the external?
What are the advantages of total suction?
gives max control of the prosthesis
allows full freedom of hip motion
good proprioceptive feedback through intimate fit
What are the disadvantages of total suction?
socket must fit very snuggly-difficult to get a good fit
cannot accommodate changes in limb volume well
suction can be lost through perspiration
potential for skin shear and abrasions
potential for skin irritation in a closed medium
requires good balance and coordination for donning
What type of suction does the user wear a sock, and must use silesian bandage/belt or pelvic belt/band to aid in the suspension?
internal socket pressure is less than external
What are the advantages to the partial suction pelvic band?
easy to don
provides rotational control
provides mediolateral pelvic stability
What are the disadvantages of the partial suction pelvic band?
adds weight to the prosthesis
usually not very comfortable
What are the advantages to the partial suction silesian belt/bandage? (sling around the waist)
lightweight additional suspension
provides some rotational control
What are the disadvantages to the partial suction silesian belt/bandage? (sling around the waist)
difficult to keep clean, unless detachable
can irritate waist
With what type of suction is a silicone liner or neoprene sleeve used? total elastic suspension
What are the advantages to no suction suspension?
provides excellent suspension
adjusts to the size of the individual
adds less weight than pelvic belt
provides for rotational control
What are the disadvantages to no suction suspension?
retains body heat which can lead to skin irritation and discomfort
wears out easily
difficult to keep clean