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PROSTHETIC COURSE

PROSTHETIC COURSE. Bryan Humble CPO/LPO Precision Prosthetics. AMPUTATION LEVELS. TRANS TIBIAL (BELOW KNEE) TRANS FEMORAL (ABOVE KNEE) HIP DISARTICULATION / HEMIPELVECTOMY. TRANS TIBIAL (BELOW KNEE). PHALANGEAL TRANSMETATARSAL LIS FRANC CHOPART SYMES TRANSTIBIAL. SHORT

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PROSTHETIC COURSE

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  1. PROSTHETIC COURSE Bryan Humble CPO/LPO Precision Prosthetics

  2. AMPUTATION LEVELS • TRANS TIBIAL (BELOW KNEE) • TRANS FEMORAL(ABOVE KNEE) • HIP DISARTICULATION / HEMIPELVECTOMY

  3. TRANS TIBIAL (BELOW KNEE) • PHALANGEAL • TRANSMETATARSAL • LIS FRANC • CHOPART • SYMES • TRANSTIBIAL • SHORT • MEDIUM • LONG

  4. TRANS FEMORAL(ABOVE KNEE) • KNEE DISARTICULATION • TRANS FEMORAL • SHORT • MEDIUM • LONG

  5. HIP DISARTICULATION / HEMIPELVECTOMY

  6. MAJOR COMPONENTS • SUSPENSION • LINER • KNEE JOINTS • SOCKET • PYLON • FOOT

  7. SUSPENSION • SUCTION • SILICONE WITH LOCK • SLEEVE • PTB CUFF • JOINT AND CORSET • BELT

  8. LINERS • SILICONE • PELITE • C-FLEX • HARD SOCKET

  9. KNEE JOINTS • LOCKING • SINGLE AXIS • SAFETY • 4-BAR • HYDRAULIC • COMPUTER CONTROLLED

  10. FEET • SACH • SINGLE AXIS • MULTI-AXIS • ENERGY STORING (SEATTLE) • DYNAMIC RESPONSE (FLEX FOOT)

  11. COMPONENT SELECTION MUST MATCH PATIENT AND ACTIVITY LEVEL. *(K-LEVEL)

  12. INSURANCE REIMBURSEMENT • MEDICARE REIMBURSEMENT • MEDICAID REIMBURSEMENT • PRIVATE INSURANCE • FUNDING SOURCES FOR AMPUTEE • TEXAS REHAB • SSD • UASA (BARR FOUNDATION) • MEDICARE USUALLY ALLOWS ONE PROSTHESIS PER YEAR IF DOCUMENTED AS MEDICALLY NECCESARY.

  13. SOCK BALANCING • SOCK BALANCE IS ONE OF THE MOST IMPORTANT FACTORS IN SUCCESSFUL PROSTHESIS USE. • 1, 2, 3 & 5 PLY SOCKS SUPPLIED • MAINTAIN “SNUG” FIT AT ALL TIMES. • SHORT SOCKS

  14. HYGENE • STUMPS SOCKS CHANGED EVERY DAY • SILICONE LINER CLEANED & DISINFECTED EVERY DAY.

  15. SHRINKER USE • MUST BE WORN ANYTIME NOT IN PROSTHESIS. (USUALLY IN THE 1ST YEAR OF POST-OP) • SHRINKERS MAINTAIN VOLUME CONSISTANCY.

  16. GAIT DEVIATIONS & CAUSES(TRANSTIBIAL) • HEEL STRIKE TO MIDSTANCE • AT MIDSTANCE • MIDSTANCE TO TOE OFF

  17. PROSTHETIC EXCESSIVE D.F. OR S.F. STIFF HEEL ANTERIOR SKT. OTHER FLEXION CONTRACTURE HEEL STRIKE TO MIDSTANCEEXCESSIVE KNEE FLEXION (CAUSES)

  18. PROSTHETIC EXCESSIVE P.F. SOFT HEEL ANTERO-DISTAL PAIN OTHER WEAK QUADS HABIT HEEL STRIKE TO MIDSTANCEABSENT KNEE FLEXION (CAUSES)

  19. PROSTHETIC MEDIAL FOOT ABDUCTED SKT. SKT. M-L LOOSE OTHER LIGAMENTOUS LAXITY @ KNEE AT MIDSTANCELATERAL THRUST (CAUSES)

  20. EARLY FLEXION (DROP OFF) ANT. DISPLACEMENT SKT. POST. DISPLACEMENT OF KEEL EX. D.F. OF FOOT SOFT D.F. BUMPER DELAYED FLEXION POST DISPLACEMENT SKT. ANT DISPLACEMENT OF KEEL EX. P.F. OF FOOT HARD D.F. BUMPER MIDSTANCE TO TOE OFF

  21. GAIT DEVIATIONS & CAUSES(TRANS FEMORAL) • LATERAL TRUNK BENDING • ABDUCTED GAIT • CIRCUMDUCTION • VAULTING • SWING PHASE WHIPS • FOOT ROTATION @ HEEL STRIKE • FOOT SLAP • UNEVEN HEEL RISE • TERMINAL IMPACT 10 UNEVEN STEP LENGTH 11 EXAGERATED LORDOSES

  22. PROSTHETIC ABDUCTED SKT. LATERAL SKT. WALL PAIN D.L. FEMUR SHORT TFB OTHER WEAK HIP ABDUCTORS ABDUCTED GAIT LATERAL TRUNK BENDING (CAUSES)

  23. PROSTHETIC PAIN IN PERONEAL AREA LONG TFP VALGUS ALIGNMENT HIP JT. MISALIGNED OTHER CONTRACTED HIP ABDUCTORS PATIENT INSECURITY - COMPENSATES WITH WIDE GAIT ABDUCTED GAIT (CAUSES)

  24. PROSTHETIC MECHANICAL OTHER INSUFFICIENT KNEE FLEXION (FEAR) CIRCUMDUCTION (CAUSES) • LOCKED KNEE • TIGHT EXT. ASSIST • TIGHT KNEE FRICTION • POOR SUSPENSION - CAUSES “PISTONING” • SKT. SMALL • EX. PF

  25. PROSTHETIC LONG TFP (LOCK, SUSP. FRICTION EX. PF. INSUFFICIENT OR EXCESSIVE KNEE FRICTION OTHER INSUFFICIENT KNEE FLEXION (FEAR) HABIT VAULTING (CAUSES)

  26. PROSTHETIC KNEE JOINT MISALIGNED TIGHT OR IMPROPER SKT. CONTURE OTHER WEAK OR FLABBY MUCULATURE SWING PHASE WHIPS (CAUSES)

  27. PROSTHETIC HARD PF CUSHION OR PF BUMPER FOOT ROTATION AT HEEL STRIKE (CAUSES)

  28. PROSTHETIC PF BUMPER TOO SOFT FOOT SLAP (CAUSES)

  29. PROSTHETIC INS. KNEE FRICTION ABSENT OR LOOSE EXT. AID OTHER FORCEFUL HIP FLEXION BY PATIENT UNEVEN HEEL RISE (CAUSES) !EXCESSIVE!

  30. PROSTHETIC EX. KNEE FRICTION EX. AID TIGHT MANUAL LOCK OTHER FEAR / AMPUTEE WALKS WITH LITTLE OR NO KNEE FLEXION UNEVEN HEEL RISE (CAUSES) !INSUFFICIENT!

  31. PROSTHETIC INS. KNEE FLEXION TIGHT EX. AID EXTENSION BUMPER DEF. OTHER AMPUTEE FEAR OF KNEE BUCKLING TERMINAL IMPACT (CAUSES)

  32. PROSTHETIC LACK OF FRICTION OR LOOSE EXT. AID INSUFFICIENT SKT. FLEXION OTHER PAIN / INSECURITY HIP FLEXION CONTRACTURE UNEVEN STEP LENGTH (CAUSES)

  33. PROSTHETIC INSUFFICIENT SKT. FLEXION INSUFFICIENT SUPPORT - ANTERIOR SKT. BRIM OTHER HIP FLEXION CONTRACTURE WEAK HIP EXTENSORS WEAK ABDOMINALS EXAGGERATED LORDOSIS (CAUSES)

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