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This presentation explores the definition, purposes, characteristics, and different types of prostheses. It also discusses the parts of a prosthesis, common problems, and the process of manufacturing prosthetic limbs.
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PROSTHESIS Presented by: Presented to: 2nd year BSC Nursing. Santhosh Thomas Lecturer YNC Reviewed by Prof. Shashikumar Updated date: 15/02/2019.
Learning objectives. The students will be able to understand the: • Define prosthesis • State its purposes • Charecteristics of a successful prosthesis • Prosthesis parts • Types of prosthesis.
Definition • Prosthesis: It’s a device designed to replace a missing part of the body or to make a part of the body work better. • Orthoses: It’s a device that supports or corrects the function of a limb or the spine.
Purpose. • A prosthesis is used to provide an individual who has an amputated limb with the opportunity to perform functional tasks, particularly ambulation (walking), which may not be possible without the limb. • The prosthesis may also be made for use during activities or sports, such as dancing, swimming, cycling, golfing, and climbing. • The type of prosthesis (artificial limb) used is determined largely by the extent of an amputation or loss and location of the missing extremity.
Specifications For Ideal Prosthesis/Orthotics. 1.Function: A) Meet Users Need B) Simple C) Easily Learned D) Dependable 2.Comfort: A) Fits Well B) Easy To Put On And Take Off C) Light Weight D) Adjustable.
Specifications For Ideal Prosthesis/Orthotics. 3.Cosmesis: • Looks ,Smells,sounds Normal • Easily Cleaned • Stain Resistant 4.Fabrication: • Fast,modular • Readily & Widely Available 5.Economics: • Affordable • Cost Effective
Characteristics of a successful prosthesis: • Be comfortable to wear, • Easy to put on and remove, • Lightweight, • Durable, and cosmetically pleasing. • Function well mechanically and require only reasonable maintenance. • Depends on the motivation of the individual, as none of the above characteristics matter if the patient will not wear the prosthesis
Problems may occur when using prosthesis are: • The poor fitting of the prostheses, causes unequal weight load to lower limbs. This may cause extra stress or pressure on the other (unaffected) leg, or on the stump. The increased pressure may lead to pain and skin problems. Skin breaks that are not treated can become infected. Over time, this may also make another amputation necessary. • Walking with prosthesis on takes extra energy. • The stump should be checked every day for redness, blisters, soreness, or swelling. • Prosthesis need to be adjusted several times before it fits well.
Prostheses (Artificial limbs) are typically manufactured using the following steps: • Measurement of the stump. • Measurement of the body to determine the size required for the artificial limb. • Creation of a model of the stump. • Formation of thermo-plasticsheet around the model of the stump – This is then used to test the fit of the prosthetic. • Formation of permanent socket. • Formation of plastic parts of the artificial limb
Different methods are used, including vacuum forming and injection molding . • Creation of metal parts of the artificial limb using die casting. • Assembly of entire limb.
Prostheses are either preparatory (temporary) or definitive (permanent) • Temporary prosthesis is fitted while the residual limb is still maturing. A preparatory prosthesis allows the patient to train with the prosthesis several months earlier in the process. Use of a preparatory prosthesis often results in a better fit for the final prosthesis, since the preparatory socket can be used to mold the residual limb into the desired shape.
During this period, the patient “test drives” the prosthesis and learns what it can and cannot do.
The advantage to using a temporary prosthesis: • It shrinks the residual limb more effectively than the elastic wrap. • It allows early bipedal ambulation. • Certain individuals can return to work. • It is a positively motivating.
It reduces the need for complex exercise program. • It can be used by individuals who may have difficulty obtaining payment for permanent prostheses.
Lower Limb Amputation. • There are several levels of lower limb amputation, including: • 1) Partial foot, 2) Ankle disarticulation, • 3) Transtibial (below the knee), • 4) Knee disarticulation, • 5) Transfemoral (above the knee), • 6) Hip disarticulation. • The most common are transtibial (mid-calf) and transfemoral (mid-thigh).
Upper Limb Prosthetics 1. The shoulder provides the centre of radius of the functional sphere of upper limb, the elbow acts a caliper to position the hand. • Multiple joint-segment activities are usually done simultaneosly,where as upper limb prostheses perform these tasks sequentially,thus limb salvaging is more critical for upperlimb.
After amputation prosthetic fitting should be done as soon as possible, even before complete wound healing has occurred. • Myoelectric prostheses provide good cosmesis & are used for sedentary work. • Body powered prosthesis are used for heavy labour.
When residual forearm is so short: supracondylar suspension (munster socket) and step up hinges can be used to augment function. • The best function with least weight at lowest cost is provided by hybrid prosthetic systems –myoelectric+bodypowered+body driven.
Lower Limb Prosthetics: • Prosthetic Knees: Used in transfemoral & knee disarticulation prostheses and chosen based on patient needs, they provide controlled knee motion.
1.Polycentric knee: • Has a moving instant centre of rotation , its recommended for: a)Patients with transfemoral amputations b)Patients with knee disarticulations c)B/L amputees
2.Stance phase control(safe/wt.activated): • Functions like a constant –friction knee during the swing phase ,freezes when weight is applied to the limb. Its used in old patients, high level amputees / use on uneven terrain.
3.Fluid Control Knee: • Allows adjustment of the response by changing resistance to knee flexion .It prevents excessive flexion
4.Constant Friction Knee: Dampen knee swing via screw/rubber pad that applies friction to the knee bolt. • Used on uneven terrain • Most common knee used in childhood prosthetics • Disadvantage: allows only single –speed walking & relies on alignment for stance phase
Summary • We have discussed in the above slides about Prosthesis. • Define prosthesis • State its purposes • Charecteristics of a successful prosthesis • Prosthesis parts • Types of prosthesis.
Conclusion • Fracture is a condition common in teenagers and are to be prevented with careful rides and safe driving, sometimes it can be caused by falls and accidents. Due to fracture we may need a treatment with limb prosthesis.
Refrences • Hinkle, J.L. & Cheever, K.H. (2018). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (14th ed.). Philadelphia: WoltersKluwer. • Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., & Harding, M.M. (2017). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (10th ed.). St. Louis: Elsevier.